Senior Process Analyst - AR Calling (RCM)

Role Summary:

This job takes the resource in providing timely delivery of assigned task and required a strong knowledge in denial management, Trend analysis and should be an expert in reviewing documents and EOB also identifying the end action to perform and a proven job knowledge in Hospital Billing.

JOB SUMMARY

This job gives an opportunity to work in a challenging environment to deliver high quality Solutions to meet the demands for our Global Customer. An ideal candidate should have experience in Hospital Billing and Denial Management. The candidate should be able to lead & own the Development of any Technical deliverables assigned to him\her & thereby delivering high quality & Innovative solutions for the client. Should be an excellent Team player & have excellent Problem solving & communication skills

ESSENTIAL RESPONSIBILITIES

• Responsible for calling Insurance companies (in US) on behalf of doctors/physicians and follow up on outstanding Accounts Receivable.
• To prioritize the pending claims for calling from the aging basket.
• Should be able to convince the claims company (payers) for payment of their outstanding claims.
• To check the appropriateness of the insurance information given by the patient if it is inadequate or unclear.
• To make a physical call by following the international norms and applicable rules for confidentiality and HIPAA compliance.
• Escalate difficult collection situations to management in a timely manner.
• Review provider claims that have not been paid by insurance companies.
• Handling patients billing queries and updating their account information.
• Post cash and write off the contractual adjustments accordingly while working on the accounts.
• Meeting daily/weekly and monthly targets set for an individual.

EDUCATION

Required

Should be a Graduate in any Stream (Mandatory)

Work Location:

EXPERIENCE

Required

1- 3 years in Revenue Cycle and Delivery Management

Preferred

• Should be willing to work in US Shift.
• Experience in Healthcare Revenue Cycle Management process.
• Strong written and verbal communication skills.
• Good computer skills including Microsoft Office suite.
• Ability to prioritize and manage work queue.
• Ability to work independently as well as in a team environment.
• Strong analytical and problem-solving skills.