Responsibilities of the Candidate:

Review outstanding insurance balances to identify and resolve issues preventing finalization of claim payment, including coordinating with payers, patients and clients when appropriate
Analyze and trend data, recommending solutions to improve first pass denial rates and reduce age of overall AR
Accounts Receivable Specialist that has an "understanding" of the whole accounting cycle / claim life cycle
Ensure all workflow items are completed within the set turn-around-time within quality expectations
Be able to analyze EOBs and denials at a claim level in addition they should find trends impacting dollar and leading to process improvements
Perform other duties as assigned
Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so

Requirements:

Graduate (10+2+3) or Btech and MBA with AR experience
18+ months of experience in AR Calling
Domain Expertise: Hands-on experience in both Physician and Hospital Billing
Hospital Billing experience
Proven experience in Hospital Billing-UB04
Solid knowledge of Denial Management within the RCM/AR domain
Solid knowledge of medical insurance (HMO, PPO, Medicare, Medicaid, Private Payers)
In-depth working knowledge of the various applications associated with the workflows
Solid knowledge and use of the American English language skills with a neutral accent
Ability to communicate effectively with all internal and external clients
Ability to use good judgment and critical thinking skills; ability to identify and resolve problems
Proficient in MS Office software; particularly Excel and Outlook
Efficient and accurate keyboard/typing skills
Solid work ethic and a high level of professionalism with a commitment to client/patient satisfaction
Functional knowledge of HIPAA rules and regulations and experience related to privacy laws, access and release of information