Company Description TruBridge is a healthcare solutions company specializing in EHR-agnostic Revenue Cycle Management solutions for organizations of various sizes. We also provide acute EHR technology services tailored for smaller hospitals. Our mission is to deliver real, measurable results quickly and efficiently, surpassing others in speed, scale, and quality. At TruBridge, we clear the way for care, ensuring healthcare providers can focus on patient care. Role Description This is a full-time, on-site role for a Manager RCM (Revenue Cycle Management) located in Chennai. The Manager RCM will oversee the daily operations of the Revenue Cycle Management team, ensuring the efficient processing of patient billing, claims, and collections. This role involves coordinating with various departments to streamline processes, implementing best practices, monitoring performance metrics, and ensuring compliance with relevant regulations and standards. Qualifications Experience in patient billing, claims processing, and collections 8-10 years of experienced in US Healthcare RCM domain, with 2 years of experienced in AM/DM role. Proficiency in EHR and RCM technologies Strong leadership and team management skills Knowledge of healthcare regulations and compliance requirements Excellent communication and interpersonal skills Analytical skills and attention to detail Bachelor's degree in healthcare administration, finance, or related field Experience in the healthcare industry is a plus
Accounts Receivable Analyst ● 2 Years of mandate experience in AR calling with Acute care/Acute business. ● Perform pre-call analysis and check the status by calling the payer or using IVR or web portal services. ● Maintain adequate documentation on the client software to send the necessary documentation to insurance companies and maintain a clear audit trail for future reference. ● Record after-call actions and perform post-call analysis for the claim follow-up. ● Provide accurate information to the insurance company, research available documentation including authorization, physician notes, medical documentation on PM system, interpret explanation of benefits received, etc. prior to making the call. ● Perform analysis of accounts receivable data and understand the reasons for underpayment, days in A/R, top denial reasons, use appropriate codes to be used in documentation of the reasons for denials/underpayments. ● Comply with all reimbursement and billing procedures for regulatory, third party, and insurance compliance norms. ● Responsible for meeting daily/weekly productivity and quality reasonable work expectations. Responsibilities ● Claim processing and submission. ● Submit the claim to insurance companies to receive payment for services rendered by a healthcare provider. ● Taking denial status from various insurance carriers ● Checking eligibility and verification of policy ● Analysis of the data ● Converting denials into payments ● Follow Health Insurance Portability and Accountability Act (HIPAA) ● Account follow up on fresh claims, denials, and appeals. ● Checking the claim status as per their suspension and denials ● Achieving weekly/monthly production and audit target Qualifications/Requirements ● High School (HSC) or graduate or equivalent with strong analytical skills. ● 2 Years of experience in accounts receivable follow-up/denial management for US healthcare. ● Good written and verbal communication skills. ● Knowledge of medical terminology, ICD10, CPT, and HCPC coding. ● Basic working knowledge of computers. ● Willingness to work continuously in night shifts. Preferred ● Familiar with healthcare patient billing systems (Practice management) like NextGen, eCW, Carecloud, Docutap. ● Familiar with clearinghouse like Waystar, Realmed Availity, change healthcare, via track. ● Proficiency with MS Excel, MS Word, google spreadsheet, etc. Other Skills and Abilities ● Ability to work independently with minimal supervision. ● Good analytical skills, assertive in resolving unpaid claims. ● Ability to multi-task and accurately process high volumes of work. ● Strong organizational and time management skills