Senior Executive

Sr. Executive:RCM Denial Management: AR caller

Overview:

Review, Call, Analyze and Manage assigned outstanding receivables portfolio by ensuring outstanding/denied claims are resolved, follow up effectively for additional information as needed with insurance companies for claims resolution, follow up with the insurance company on the outstanding/denied claims and resolve them within the timelines and defined Service Level Agreements (SLA's),

Qualifications:

Graduation in any stream

Experience:

BPO Experience - 2-5 years

US Healthcare AR experience preferred

Communication Skill:

Excellent oral and written communication skills

Working Hours:

40 hours per week as Full-time employee

Shift time: 7:30 PM IST - 4:30 AM IST

Weekends Off

Telecommuter/Internet requirements, if applicable:

High Speed internet connection at home, must be broadband

Must understand and adhere with telecommuter policy

Skills and abilities:

1. Interact and probe the insurance representative to get the required status update and have the claim resolved,
2. Ensure Daily Productivity targets are met at the required quality level on the assigned inventory,
3. Perform timely follow up on claims to avoid revenue loss, Prioritize the pending claims for calling from the aging bucket,
4. Review claims that have not been paid by insurance companies,
5. Check insurance information provided by patient if it is insufficient or unclear,
6. Follow the guidelines and applicable rules while calling insurance companies for confidentiality and HIPAA compliance,
7. Escalate difficult collection situations to management in a timely manner, Handling patients billing queries and updating their account information,
8. Post cash and write off the contractual adjustments accordingly while working on the accounts,
9. Meeting daily/weekly and monthly targets set for an individual.