ESP Engineered in Ahmedabad is seeking a results-oriented individual to manage insurance billing and denial resolution. The ideal candidate will be a graduate with a strong command of English, analytical skills, and the ability to propose process improvements. This role includes maintaining performance metrics with payors, ensuring high collection rates, and addressing compliance issues in billing. Join us in a career-focused environment where your skills will have a significant impact.
Qualifications
Good comprehension of and command over English language.
Good analytical skills with above average logic and reasoning ability.
Career focused and result oriented.
Responsibilities
Resolve denials by working with Payors and escalate to leadership.
Review AR for collection feasibility.
Propose process improvements for recurring issues.
Maintain communication with Payors on policy changes.
Support development of Payor performance metrics.
Maintain First Pass resolution rate above 90%.
Keep Client Review AR aging under 10% for 120+.
Monitor AR aging to stay below 20% for 90+.
Skills
Claim Status Checking
Follow-up AR Process Knowledge
Denials Management
Insurance Guidelines
Payer Policies
Education
Graduate in any stream
Job description
Responsibilities
Denials resulting from non-compliance to Payor billing requirements, work with the Payor to find a resolution, and implement the correction by escalating to Leadership
Review 120+ AR for collection feasibility and determine adjustments required
Propose process improvements to address repeated issues or trends
Apply knowledge of insurance billing information including modifiers, authorization criteria, CPT, ICD-10 coding and payor specific requirements
Maintain communication with Payors regarding changes to policies and procedures and communicate the same to Leadership
Support the development and maintenance of Payor performance metrics (Denial Rate by payor, Gross Collection Rate by payor etc.)
Maintain the First Pass resolution rate for practices at 90% or above
Always maintain the aging of Client Review AR bucket at less than 10% for 120+ and less than 20% for 90+ AR
Requirements
Graduate in any stream.
Good comprehension of and command over English language.
Good analytical skills. Above average logic and reasoning ability.
Career focused and Result oriented.
Required Skills
Claim Status Checking & Follow-up AR Process Knowledge denials management Insurance Guidelines & Payer Policies