Ar Associate

Omega Healthcare Management Services

0-1 years

Not Disclosed

Tiruchirappalli

3 Dec. 2, 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

Job Title: AR Associate - Denials Processing & Claims Follow-up

Department: Accounts Receivable (AR)

Job Location: [Location]

Reporting To: Supervisor/Manager

Role Description Overview:

The AR Associate is responsible for managing day-to-day activities related to Denials Processing, Claims Follow-up, and Customer Service. This role ensures the timely resolution of claim denials, effective communication with insurance carriers, and adherence to client specifications and quality standards.

Key Responsibilities:

Denials Processing & Claims Follow-Up:

Review and process emails for updates related to claims and denials.
Contact insurance carriers to follow up on denied claims and document interactions in software and spreadsheets.
Take appropriate action based on communication with insurance carriers and follow-up requirements.
Escalate complex issues or unresolved claims to the immediate supervisor.

Client Requirements & Productivity Targets:

Understand client-specific requirements and project specifications to ensure accurate and timely processing of claims.
Ensure targeted collections are met on a daily and monthly basis.
Meet productivity targets set by clients within the agreed-upon timelines.

Quality & Reporting:

Ensure that all deliverables adhere to client quality standards and requirements.
Follow up on pending claims and take necessary actions to resolve issues.
Regularly update and maintain production logs and status reports to ensure accurate tracking of claim resolution activities.

Desired Profile:

Education:

A bachelor’s degree or equivalent in a related field.

Skills:

Strong knowledge of denials processing and claims follow-up procedures.
Good communication and negotiation skills.
Ability to work with insurance carriers and understand the details of medical claims.
Excellent organizational and time-management skills to meet deadlines and productivity targets.
Familiarity with claim management software and tools.

Work Mode:

[Onsite/Hybrid]

This role is ideal for individuals with strong analytical skills, an understanding of healthcare claims, and the ability to work under pressure to meet deadlines and client expectations.

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Ar Associate

Job Description

Role Description Overview:

Key Responsibilities:

Denials Processing & Claims Follow-Up:

Client Requirements & Productivity Targets:

Quality & Reporting:

Desired Profile:

Education:

Skills:

Work Mode:

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