AR Analyst Denials | Oncology & Radiology

Billedright Healthcare Solutions; Chennai District; Sur place; INR 480 000 - 600 000; Plein temps

Résumé du poste

Billedright Healthcare Solutions seeks an experienced AR Denials Analyst in Chennai to analyze denied claims, identify root causes, and drive timely reversals to maximize collections.

You will work with US payers, leverage Veradigm Pro PM and Practice EDI Insight, and apply CPT/ICD-10 knowledge to reduce AR aging and DSO.

Immediate joiners preferred and you will collaborate with a specialized team to meet KPIs.

Qualifications

• 4–7 years of US Healthcare RCM / AR Denials experience.
• Knowledge of CPT, ICD-10, HCPCS, modifiers, authorization and medical necessity.
• Proficiency with Veradigm Pro PM and Practice EDI Insight.
• Location Chennai, India.

Responsabilités

• Analyze denied claims and identify root causes to drive timely resolutions.
• Manage AR work queues within Veradigm Pro PM and prioritize aging claims.
• Submit appeals to carriers and monitor status for timely follow-up.
• Review credit balances and process refund requests and corrections.
• Maintain client communication logs and ensure timely responses.
• Stay updated on radiation oncology coding and related workflows.
• Ensure compliance with applicable laws and regulations and protect patient confidentiality.
• Collaborate with AR Manager and team to meet DSO and KPI targets.

Connaissances

Veradigm Software

US Healthcare AR

Oncology Billing

Radiology Billing

Analytical Skills

Communication Skills

Description du poste

Job Description

We are looking for an experienced AR Analyst Denials with strong expertise in US Healthcare RCM, specifically handling Oncology and Radiology claims. The candidate will be responsible for analyzing denied claims, identifying root causes, taking appropriate corrective action, and ensuring timely resolution to maximize collections and reduce AR aging.

Key Responsibilities

• Demonstrates thorough understanding of the accounts receivable functions; compliant with federal and applicable state regulations and our organization's policy and procedures.
• Daily works assigned insurance accounts receivable AR work queues within Veradigm Pro PM.
• Identifies payer trends and/or claim submission issues and reports to assigned AR Manager immediately.
• Works credit balance AR and prepares refund requests and/or posting error corrections in an effort to resolve credit balances timely. (line item, claim level and/or account level credit balances)
• Submits written appeals to insurance carriers when applicable and ensures timely follow-up regarding status.
• Maintains tickler file via AR work queues in Veradigm Pro PM and ensures timely follow-up of outstanding claims/balances.
• Daily utilizes the Client Communication Log (CCL) per client ensuring timely responses from client for resolution.
• Maintains working day to day knowledge of the practice management system. (Veradigm Pro PM and Practice EDI Insight).
• Maintains strong working knowledge of Radiation Oncology coding or the specific specialty in which the accounts receivable is assigned.
• Ensures strong communication with management and team members.
• Ensures compliance with appropriate industry regulations and state and federal regulations.
• Maintains working knowledge of applicable laws and regulations as they relate to assigned responsibilities.
• Maintains confidentiality of all information related to patients, medical staff, finances and cost effective health care delivery issues.
• Strives to achieve and maintain company Days Sales Outstanding (DSO) and Account Receivable aging standards. (Company benchmarks/KPIs)
• Demonstrates the ability to work well with peers while ensuring a strong cohesive team.

Preferred Experience

• Experience in Veradigm Software
• Experience in US Healthcare AR / Denials Management.
• Strong exposure to Oncology and Radiology billing.
• Good understanding of US insurance payers and RCM workflows.
• Knowledge of CPT, ICD-10, HCPCS, modifiers, authorization and medical necessity.
• Immediate Joiners preferred
• Strong analytical, communication, and follow-up skills.
• Experience: 4-7 years in US Healthcare RCM / AR Denials.
• Location : Chennai

Interested Candidates

Interested Candidates can reach to the below mentioned contact number:

Damy - 8778691270

Farjana - 8748794767

Billed Right does not discriminate on the basis of race, sex, color, religion, age, national origin, marital status, disability, veteran status, genetic information, sexual orientation, gender identity, or any other reason prohibited by law in the provision of employment opportunities and benefits