Senior Executive

As a QA RCM, you will be responsible for auditing the work of RCM Callers to ensure the highest standards of service delivery.

REQUIRED EDUCATION/EXPERIENCE: ;Should be Graduate

Should have worked as a ;Quality Controller for AR for at least one year ;with medical billing service providers or should have minimum 5 years experience into AR

Must have very good knowledge of medical billing and be confident in process knowledge.

Experience in the end-to-end Healthcare process and AR team for the ; audit

Adapting to new situation challenges whenever required.Adhere to all company policies and procedures

POSITION RELATIONSHIPS: Reports directly to the Assistant Manager ;

JOB RESPONSIBILITIES:

Review the work performed by AR team and document any quality issues. ;Review call quality issues on various parameters such as conversational skills, claims resolution, and voice quality.

Participate in developing process documentation.Provide feedback and work with the training team to provide remedial training.Check the reports developed by AR team - aging analysis, understanding days in A/R, top reasons for denials, etcAlways be at the forefront of ethical behavior and never be a bystander.

PROFESSIONAL: Recognize and respect cultural diversity. ;Adapt communication to an individual s ability to understand. Use medical terminology appropriately.

Respond to communications received within a reasonable time frame. ;Project a professional manner and image. ;Adhere to ethical principles. ;Demonstrate initiative and responsibility. ;Work as a team member. ;Efficient Time Management. ;

Prioritize and perform multiple tasks. ;Adapt to change, including new hours of operation and methodology. ;Attend functional team meetings and mandatory in-service education. ;Maintain proper observation and adherence to company policies and procedures. ;

KNOWLEDGE, SKILLS, AND EXPERIENCE:

Should have worked as a Quality Controller for AR for at least one year with AR providers or should have worked more than 6 years into ARMust have very good knowledge of AR and be confident in process knowledge.

Experience in the end-to-end Healthcare process and AR Team for the ;auditAdapting to new situation challenges whenever required.Adhere to all company policies and procedures

LEGAL and COMPLIANCE:

Maintain patient and company confidentiality. ;Practice within the scope of education, training, and personal capabilities. ;Document company documents (hard copy and electronic) accurately. ;Use appropriate guidelines for releasing information. ;

Maintain awareness of US federal and US state health care legislation and regulations, PHI, HIPAA ;WORKING HOURS:40 hours per week as Full-time employeeShift time: 01:30AM TO 10:30PM IST

Weekends Off TELECOMMUTER / INTERNET REQUIREMENT:

High Speed internet connection at home, must be broadband with minimum of 100 MBPS Speed or aboveMust understand and adhere with telecommuter policyMust have power backup at to mitigate power outage ;