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Executive / Sr. Executive - Ar - Hospital Billing

1-3 years
Not Disclosed
10 Dec. 6, 2024
Job Description
Job Type: Full Time Education: B.Sc./M.Sc./B.Pharm/M.Pharm/Life science Skills: Causality Assessment, Clinical SAS Programming, Communication Skills, CPC Certified, GCP guidelines, ICD-10 CM Codes, CPT-Codes, HCPCS Codes, ICD-10 CM, CPT, HCPCS Coding, ICH guidelines, ICSR Case Processing, Interpersonal Skill, Labelling Assessment, MedDRA Coding, Medical Billing, Medical Coding, Medical Terminology, Narrative Writing, Research & Development, Technical Skill, Triage of ICSRs, WHO DD Coding

Position: Executive / Senior Executive - Accounts Receivable (Hospital Billing)
Location: Bengaluru, Hyderabad, Chennai


Job Summary

We are seeking a detail-oriented and proactive individual to join our team as Executive/Senior Executive - AR (Hospital Billing). In this role, you will be responsible for managing Accounts Receivable (AR) for U.S. healthcare providers, ensuring timely follow-up with insurance companies, and achieving claim resolutions effectively.


Key Responsibilities

  • Contact U.S. insurance companies on behalf of physicians, clinics, and hospitals to follow up on outstanding AR.
  • Persuade insurance payers to settle outstanding claims efficiently.
  • Demonstrate sound knowledge of the U.S. healthcare domain (provider side) and suggest improvements to processes.
  • Apply a basic understanding of Revenue Cycle Management (RCM).
  • Maintain and develop collateral materials as required.
  • Consult Team Leaders for client updates and adhere to quality and productivity targets.
  • Identify and escalate issues to the Team Leader/Manager as needed.
  • Update production logs and ensure compliance with company policies, rules, and HIPAA guidelines.
  • Follow quality processes, including the use of checklists.
  • Comply with QMS and ISMS policies and procedures.
  • Specialize in Transplant/Gift of Life/Organ Procurement billing, ensuring accurate claim submissions for organ procurement.

Eligibility Criteria

  • Experience: 1-3 years of relevant experience in U.S. provider-side AR activities.
  • Skills:
    • Hands-on experience in claim analysis and follow-up with insurance companies.
    • Excellent oral and written communication skills.
    • Familiarity with specialty billing, particularly transplant and organ procurement, is advantageous.
    • Knowledge of EPIC software is desirable.
    • Willingness to work on claims <$5,000 at Day 60 from the bill date within designated work queues in EPIC.
  • Work Environment:
    • Ready to work from the office during U.S. EST hours.

Preferred Qualifications

  • Expertise in managing AR for claims related to organ procurement and transplant billing.
  • Strong understanding of healthcare compliance guidelines, including HIPAA.
  • Proven ability to meet quality and productivity targets with strict turnaround times (TAT).

Join us in delivering high-quality services to healthcare providers and driving operational excellence in U.S. hospital billing processes.