Job Title: Senior Executive – Accounts Receivable (AR)
Department: Accounts Receivable / Healthcare Operations
Reporting To: AR Manager / AR Supervisor
Role Description Overview:
The Senior Executive – Accounts Receivable (AR) is responsible for overseeing the day-to-day AR activities, including denials processing, claims follow-up, and resolution. This role ensures that all claims are processed accurately, issues are identified and escalated, and productivity and collection targets are met. The Senior Executive will also be responsible for supervising junior AR staff, providing guidance, and ensuring compliance with client specifications, quality standards, and timelines.
Key Responsibilities:
Claims Processing & Denials Management:
Lead the process of reviewing and following up on denied claims, ensuring that all actions are documented and handled effectively.
Monitor and address issues related to denials, payment follow-ups, and escalations, ensuring timely resolution.
Analyze and identify trends in claim denials to help prevent future occurrences and improve overall claim resolution rates.
Perform detailed reviews of AR reports to ensure accuracy and proper documentation of claim statuses.
Supervision & Mentorship:
Oversee a team of AR Associates, providing guidance, mentorship, and training to junior staff.
Ensure junior staff members adhere to client-specific guidelines, productivity targets, and quality standards.
Review and evaluate team members’ performance and provide constructive feedback for improvement.
Escalate unresolved issues to higher management while ensuring timely issue resolution at the team level.
Client & Insurance Carrier Communication:
Maintain proactive communication with insurance carriers and clients to resolve claims and payment issues.
Address complex inquiries related to claims and denials, ensuring the timely and accurate resolution of client queries.
Build and maintain strong relationships with clients and insurance carriers to ensure effective claims management.
Data Management & Reporting:
Prepare and maintain detailed reports on claims, denials, and collections performance.
Track and monitor AR metrics, ensuring that all key performance indicators (KPIs) are met, including resolution timelines and collection targets.
Provide regular updates on AR activities and performance to senior management and clients.
Process Improvement & Compliance:
Identify and implement improvements to the AR process to enhance efficiency, accuracy, and resolution times.
Ensure that AR operations comply with internal policies, client requirements, and industry regulations.
Ensure adherence to quality standards and provide corrective actions to resolve discrepancies in claims processing.
Escalation Management:
Handle high-priority escalations, including disputes with clients or insurance carriers, and ensure timely resolution.
Analyze recurring issues in denials or payment processes and work with the team to implement corrective actions.
Desired Profile:
Experience:
Minimum 4-6 years of experience in Accounts Receivable, preferably in the healthcare or insurance sector.
Proven experience in managing AR operations, claims processing, denials, and follow-up.
Experience in mentoring and supervising a team of AR professionals.
Skills and Competencies:
Strong understanding of healthcare claims management, insurance policies, and AR processes.
Excellent communication skills, both written and verbal, with the ability to communicate complex information clearly to clients and team members.
Strong problem-solving skills with the ability to analyze complex issues and implement effective solutions.
Proficiency in healthcare billing software, AR tools, and spreadsheet management.
Detail-oriented with excellent organizational and multitasking skills.
Strong leadership skills and ability to motivate and guide a team to achieve targets.
Education:
Bachelor's degree in Finance, Accounting, Business Administration, or a related field.
Additional certifications in healthcare billing or AR management (e.g., CPC, CCS, etc.) are a plus.
Shift Details:
General Shift / Day Shift
Work Mode:
Work From Office (WFO)
This role is ideal for an experienced AR professional with a strong background in claims processing, denials management, and team leadership. The Senior Executive – AR will have a significant impact on the efficiency and effectiveness of the AR operations and will be key to ensuring timely collections and overall financial performance.
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