Process Analyst_AR Caller

enGen Global; Hyderabad, Chennai; On-site; INR 450,000 - 650,000; Full time

Job summary

enGen Global Hyderabad seeks a skilled Revenue Cycle specialist with 1-3 years of experience in Hospital/Physician Billing and Denial Management. You will lead the development of technical deliverables, delivering high-quality solutions and working with a team to improve claim payments.

The ideal candidate will call insurance companies, follow up on AR, prioritize aging claims, ensure HIPAA confidentiality, and communicate effectively to achieve daily to monthly targets. US shift is required.

Qualifications

• 1-3 years in Revenue Cycle and Delivery Management.
• Willing to work in US shift.
• Experience in Healthcare Revenue Cycle Management.
• HB PB experience is an added advantage.
• Calling experience is mandatory.
• Strong written and verbal communication skills.
• Strong analytical and problem-solving skills for 180+ days claims.

Responsibilities

• Calling Insurance companies (in US) on behalf of doctors/physicians and follow up on outstanding Accounts Receivable.
• Prioritize the pending claims for calling from the aging basket.
• Convince payers for payment of their outstanding claims.
• Check the accuracy of insurance information provided by patients.
• Make calls following confidentiality and HIPAA compliance.
• Escalate difficult collection situations to management in a timely manner.
• Review provider claims that have not been paid by insurance companies.
• Handle patients, billing queries and update their account information.
• Post cash and write off the contractual adjustments accordingly while working on the accounts.
• Meet daily/weekly and monthly targets.

Skills

Denial management

Trend analysis

EOB review

Hospital billing

Physician billing

HIPAA compliance

Communication skills

Problem solving

MS Office

Team player

Education

Graduate degree

Tools

Allscripts Sunrise

NextGen

Job description

Role Summary

This job takes the resource in providing timely delivery of assigned tasks and required a strong knowledge in denial management, Trend analysis and should be an expert in reviewing documents and EOB also identifying the end action to perform and a proven job knowledge in Hospital Billing/Physician Billing.

Job Summary

This job gives an opportunity to work in a challenging environment to deliver high quality Solutions to meet the demands for our Global Customer. An ideal candidate should have experience in Hospital/Physician Billing and Denial Management. The candidate should be able to lead own the Development of any Technical deliverables assigned to him/her thereby delivering high quality Innovative solutions for the client. Should be an excellent Team player have excellent Problem solving communication skills

Essential Responsibilities

• Responsible for calling Insurance companies (in US) on behalf of doctors/physicians and follow up on outstanding Accounts Receivable.
• To prioritize the pending claims for calling from the aging basket.
• Should be able to convince the claims company (payers) for payment of their outstanding claims.
• To check the appropriateness of the insurance information given by the patient if it is inadequate or unclear.
• To make a physical call by following the international norms and applicable rules for confidentiality and HIPAA compliance.
• Escalate difficult collection situations to management in a timely manner.
• Review provider claims that have not been paid by insurance companies.
• Handling patients, billing queries and updating their account information.
• Post cash and write off the contractual adjustments accordingly while working on the accounts.
• Meeting daily/weekly and monthly targets set for an individual.

Education

• Required
• Should be a Graduate in any Stream

Experience

• 1- 3 years in Revenue Cycle and Delivery Management
• Preferred
• Should be willing to work in US Shift.
• Experience in Healthcare Revenue Cycle Management process
• Having experience in both HB PB is added advantage
• Calling Experience is mandatory
• Allscripts Sunrise and NextGen software knowledge is required
• Strong written and verbal communication skills.
• Good computer skills including Microsoft Office suite.
• Ability to prioritize and manage work queue.
• Ability to work independently as well as in a team environment.
• Strong analytical and problem-solving skills in over 180+ days claims.