Sr Process Executive - Product Management

Job Summary:

Senior Executive Analyst Product Management

Key Responsibilities:

• Analyze claim payments to identify discrepancies, denials, or shortfalls and determine the root cause up to the payment posting level.
• Accurately calculate and validate line postings, ensuring all transactions are balanced and aligned with expected payment structures.
• Apply deep domain knowledge in

  medical billing AR

  and

  payment processes

  to resolve complex account issues.
• Demonstrate strong problem-solving skills to interpret data, resolve posting errors, and streamline payment workflows.
• Collaborate and communicate effectively with both

  Operations

  and

  Technology teams

  , ensuring accurate requirement gathering and translation of business needs into technical solutionsand vice versa.
• Provide training, guidance, and mentorship to junior team members as needed.
• Must work closely with Technology team on fine tuning Payment posting tool (Ensuring the program handles the posting similar to Posting agent)
• Must perform UAT Testing / to confirm the proposed changes are deployed as expected in Pcube.
• Must prepare appropriate rules / formulae to do the calculation based on Scenarios in Payment posting
• Must analyze Trend and provide a fix
• Mapping ANSI codes to Remark codes

Required Skills & Qualifications:

• Minimum [24+] years of hands-on experience in

  Payments domain

  . (Any other Domain will be considered as added Advantage)
• In-depth knowledge of claim lifecycle, denial management, and payment posting.
• Strong analytical skills, with attention to detail in calculating and balancing line-level postings.
• Experience working as an SME/QCA in a medical billing environment is highly desirable.
• Excellent communication and coordination skills for cross-functional collaboration.
• Proficiency in MS Excel, AR software tools, and healthcare RCM platforms.
• Must work under minimal supervision
• Must interpret the EOB and write the calculations as rules/formulae to have the scenario coded
• Must Track all the Open issues and provide the fix within the ETA
• Ready to learn UAT testing skills
• Should be ready to Work in Office

Preferred Qualifications:

• Experience with U.S. healthcare
• Prior experience working in client-facing or project coordination roles.
• Knowledge of HIPAA and healthcare compliance regulations.

For More Details contact:

Send your CV to this What's app - 9884753573