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    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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