A career in our Managed Services team will provide you an opportunity to collaborate with a wide array of teams to help our clients implement and operate new capabilities, achieve operational efficiencies, and harness the power of technology. Our Revenue Cycle Managed Services team will provide you with the opportunity to act as an extension of our healthcare clients revenue cycle functions. We specialize in front, middle and back office revenue cycle functions for hospitals, medical groups, and other providers. We leverage our custom and automated workflow and quality assurance products to enable our clients to achieve better results, which ultimately allow them to provide better patient care.
To really stand out and make us fit for the future in a constantly changing world, each and every one of us at PwC needs to be a purpose-led and values-driven leader at every level. To help us achieve this we have the PwC Professional; our global leadership development framework. It gives us a single set of expectations across our lines, geographies and career paths, and provides transparency on the skills we need as individuals to be successful and progress in our careers, now and in the future.
Responsibilities
As a Specialist, you'll work as part of a team of problem solvers, helping to solve complex business issues from strategy to execution. PwC Professional skills and responsibilities for this management level include but are not limited to:
- Conduct self in a professional manner and take responsibility for work and commitments.
- Flex approach to meet the changing needs of teams and clients.
- Identify and make suggestions for efficiencies and improvements when performing work.
- Take action to stay current with new and evolving technology.
- Use tools, techniques and firm standard methodologies to support research, analysis and problem solving.
- Handle, manipulate and analyse data and information responsibly.
- Communicate with empathy and adapt communication style to meet the needs of the situation and audience.
- Manage expectations of stakeholders effectively.
- Embrace different points of view and welcome opposing and conflicting ideas.
- Uphold the firm's code of ethics and business conduct.
Job Summary -
A career in our Managed Services team will give you an opportunity to collaborate with many teams to help our clients implement and operate new capabilities, achieve operational efficiencies, and harness the power of technology. Our Revenue Cycle Managed Services team will provide you with the opportunity to act as an extension of our healthcare clients revenue cycle functions. We specialize in front, middle and back-office revenue cycle functions for hospitals, medical groups, and other providers. We leverage our custom and automated workflow and quality assurance products to enable our clients
to achieve better results, which ultimately allows them to provide better patient care.
Minimum Degree Required (BQ) *:
Bachelor's Degree
Degree Preferred
Bachelor's Degree
Required Field(s) Of Study (BQ)
Computer Science, Data Analytics, Accounting
Preferred Field(s) Of Study
Minimum Year(s) of Experience (BQ) *: US
1 year of experience
Certification(s) Preferred
Required Knowledge/Skills (BQ):
Preferred Knowledge/Skills *:
Job Description Summary
Insurance Follow-Up:
Contact insurance companies via phone, email, or online portals to follow up on outstanding claims. Identify and resolve issues causing payment delays, such as claim denials or underpayments. Verify claim status, appeal denied claims and resubmit claims when necessary.
Documentation and Reporting: Maintain accurate and detailed documentation of all communications and actions taken. Update account information and billing systems with payment details and follow-up notes. Generate reports on accounts receivable status, aging trends, and collection efforts.
Compliance and Regulations: Adhere to HIPAA regulations and guidelines to ensure patient confidentiality and data security. Stay informed about insurance policies, billing guidelines, and industry changes affecting reimbursement.
Team Collaboration: Collaborate with internal departments, including billing, coding, and collections teams, to resolve payment issues. Participate in meetings and discussions to improve revenue cycle processes and workflow.
Requirements
Proven experience (1-2 years) in healthcare revenue cycle management, specifically in accounts receivable follow-up and collections.
Strong understanding of medical billing processes, insurance claims, and reimbursement methodologies.
Excellent communication skills with the ability to effectively interact with insurance companies, patients, and internal stakeholders.
Proficiency in using billing software, electronic health records (EHR), and Microsoft Office applications.
Attention to detail and ability to prioritize tasks to meet deadlines.
Knowledge of medical coding (ICD-10, CPT) is a plus.
Experience Level: 1 to 2 years.
Shift timings: Flexible to work in night shifts (US Time zone)
Preferred Qualification: Bachelor's degree in finance or Any Graduate
