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    Ar Associate

    Omega Healthcare Management Services
    0-1 years
    Not Disclosed
    Bengaluru
    2 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 / Customer Service)
    Department: Accounts Receivable
    Location: [Location]
    Reporting To: Immediate Supervisor / Team Lead

    Role Description Overview:

    The AR Associate is responsible for managing the day-to-day activities related to Denials Processing, Claims Follow-up, and Customer Service. The role involves reviewing communication from insurance carriers, following up on outstanding claims, documenting the necessary details, and ensuring timely and accurate processing of accounts receivable.

    Responsibility Areas:

    Claims Management & Denials Processing

    • Review emails for updates from insurance carriers regarding claims and denials.
    • Call insurance carriers to discuss denied or pending claims, document the conversation in the software and spreadsheet, and take appropriate action to resolve issues.
    • Follow up on pending claims to ensure timely resolution and payment.
    • Identify recurring issues with claims processing or denials and escalate them to the immediate supervisor for further action.

    Data Management & Reporting

    • Update and maintain production logs and ensure they are accurately documented.
    • Prepare and maintain status reports regarding claims follow-up, denials, and overall progress.
    • Monitor and document all actions taken regarding claims, ensuring data integrity and transparency.

    Customer Service & Client Interaction

    • Ensure that client requirements and specifications are understood and adhered to for each claim.
    • Ensure follow-ups are made within the stipulated time and productivity targets for claims recovery are met.
    • Ensure that client deliverables are completed within the agreed timelines and quality standards.

    Escalation & Issue Resolution

    • Identify any issues in the claims processing workflow and escalate them to the supervisor or relevant department promptly.
    • Work towards resolving issues in a timely and efficient manner, ensuring minimal delay in payments or resolution of claims.

    Desired Profile:

    Qualifications & Skills:

    • Understanding of healthcare claims, denials, and the accounts receivable process.
    • Excellent verbal and written communication skills for customer interaction and documentation.
    • Detail-oriented with strong organizational skills.
    • Ability to work under pressure and meet deadlines while maintaining a high standard of work quality.
    • Proficiency in relevant software for data entry, documentation, and reporting.
    • Ability to meet productivity targets on a daily and monthly basis.

    Experience:

    • Prior experience in accounts receivable, denials management, claims follow-up, or customer service is preferred but not mandatory.
    • Knowledge of insurance policies, healthcare claims, and the medical billing process is advantageous.

    Key Competencies:

    • Strong problem-solving skills and attention to detail.
    • Ability to multitask and prioritize tasks efficiently.
    • Ability to handle customer queries and claims issues with professionalism and urgency.
    • Ability to collaborate with team members and escalate issues when necessary.

    How to Apply:

    Interested candidates are encouraged to submit their resume along with a cover letter explaining their experience and interest in the AR Associate role.

    This AR Associate position offers an exciting opportunity for individuals with an interest in healthcare billing, denials processing, and claims follow-up. By ensuring claims are handled efficiently, you will play a key role in the success of the organization’s accounts receivable operations.

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