Senior Ar Caller

Job Title: AR Analyst Location: Noida Employment Type: Full-Time Company Overview: Jindal Healthcare Who we are and what we do? At Jindal Healthcare, we are a proud member of the renowned OP Jindal Group, we are traditionally known for our leadership in steel manufacturing and heavy industrial work. However, in recent years, weve shifted our focus to providing innovative technology and outsourcing services within the healthcare sector. Our parent company, Jindal X, a subsidiary of Jindal Sawone of the groups major entitieswas founded over 25 years ago. In the past 7-8 years, we've pivoted into providing Revenue Cycle Management (RCM) services and solutions in the U.S., targeting physician groups, regional hospitals, rural hospitals, and small to mid-sized healthcare providers. What sets us apart in the marketplace is two-fold. First, weve developed a proprietary tool, HealthX, that enhances the visibility of the revenue cycle process, allowing us to deliver more efficient and insightful solutions compared to other players in the industry. Secondly, we differentiate ourselves by prioritizing output metrics more than traditional outsourcing firms, ensuring better value within competitive price points. Rather than simply focusing on volume (number of claims worked) and audit scores, we integrate a consulting layer into our service offering. This allows us to directly contribute to improving our clients' overall revenue while simultaneously reducing their cost to collect. We launched this division about eight years ago with a joint venture to learn the ins and outs of the revenue cycle. For the past 4-5 years, weve independently operated and grown the business, building an onshore presence for sales, marketing, and client services. Our goal is to continue our exponential growth, with plans to double in size every year over the next 3-4 years. Roles and Responsibilities- Technical Skills: 1. Medical Billing Systems: Familiarity with popular billing software such as Epic, Cerner, Meditech, NextGen, ClinicalWorks, Modmed, or PHIMed. Experience with HCFA-1500 forms, UB-04 forms, and other insurance-specific claim forms. 2. Domain Knowledge: ¢ ¢ ¢ Handle medical billing processes for various insurance types, including Medicare, Medicaid, HMO, commercial insurance, and Workers' Compensation. Experience in denials management, including identifying denial reasons, appeals process, and follow-up to resolve denials promptly. Strong understanding of insurance types, including Medicare, Medicaid, HMO, commercial insurance, and Workers' Compensation.

¢ ¢ ¢ Proficiency in CPT, ICD-10, and Modifiers to assign correct codes and ensure compliance with coding standards. Demonstrate a basic understanding of revenue cycle management to optimize billing procedures and revenue generation. Manage denials effectively by identifying reasons for denials, initiating appeals, and following up to ensure resolution and minimize revenue loss. 3. Claim Submission & Denial Management: ¢ ¢ Proficient in claim submission through EDI (Electronic Data Interchange) or other methods. Experience managing claim denials and rejections, appealing denied claims, and identifying the reason behind denials. ¢ Ability to correct errors in coding or documentation to ensure proper reimbursement. 4. Compliance & Regulations: ¢ ¢ Deep understanding of HIPAA regulations to ensure patient confidentiality and compliance. Awareness of insurance payer guidelines, federal/state regulations, and any updates to medical billing practices. ¢ Knowledge of Medicare/Medicaid billing guidelines and commercial payer contracts. a Soft Skills: 1. Analytical Thinking & Problem Solving: ¢ ¢ Strong ability to analyze AR aging reports and identify patterns in denied claims or underpayments. Ability to develop solutions for recurring issues by investigating root causes and collaborating with cross-functional teams. 2. Attention to Detail: ¢ ¢ Precision in reviewing and processing claims to ensure all necessary information is provided, reducing the likelihood of rejections. Ability to identify discrepancies or errors in claims data and take corrective actions quickly. 3. Communication Skills: ¢ Strong verbal and written communication skills to interact with insurance companies, healthcare providers, and patients. ¢ ¢ Ability to explain billing and claims issues clearly to patients or healthcare providers. Good interpersonal skills to maintain effective working relationships with external parties (e.g., payers, customers) and internal teams. 4. Time Management & Organization: ¢ ¢ Ability to handle multiple claims, follow up on overdue payments, and prioritize urgent issues in a busy environment. Managing deadlines for claims follow-ups and appeals while maintaining accurate documentation.

Additional Skills: 1. Patient Billing & Collection: ¢ ¢ Experience handling patient billing inquiries, payment arrangements, and explaining charges to patients. Knowledge of patient statements, explanation of benefits (EOBs), and processing patient payments. 2. Knowledge of Reimbursement Rates: ¢ Understanding of contractual agreements with insurance companies and the ability to apply the correct reimbursement rates. 3. Critical Thinking: ¢ Ability to assess complex billing scenarios and come up with effective solutions (e.g., multiple payers, complex claim issues, etc.). 4. Adaptability: ¢ ¢ ¢ Ability to stay updated on changes in coding standards, payer policies, and government regulations. Flexible in adjusting to evolving requirements in medical billing processes and payer requirements. Working knowledge of HIPAA and healthcare compliance. 5. Team Collaboration: ¢ Ability to work as part of a team, particularly with coding specialists, providers, and other departments, to ensure claims are processed correctly. Additional Software/Tools Knowledge: ¢ ¢ ¢ Microsoft Excel for data analysis and reporting. AR Aging Reports and understanding their components (e.g., Current, 30-60-90+ Days, etc.). Revenue Cycle Management (RCM) tools for tracking claim status and financial performance. Key Performance Indicators (KPIs) for AR Analysts in Medical Billing: ¢ ¢ ¢ ¢ Days Sales Outstanding (DSO) Time taken to collect payment after a service is provided. Claim Denial Rate Percentage of claims rejected or denied. First Pass Resolution Rate Percentage of claims processed without needing corrections. Collections Percentage Total collections compared to expected collections.