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Executive / Sr. Executive – Ar – Physician Billing

1-3 years
Not Disclosed
10 Dec. 6, 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

Here’s a refined version of the job description:


Position: Executive / Senior Executive - Accounts Receivable (Physician Billing)
Location: Bengaluru, Hyderabad, Chennai


Job Summary

We are seeking a dedicated and results-driven individual to join our team as Executive/Senior Executive - AR (Physician Billing). In this role, you will be responsible for managing Accounts Receivable (AR) for U.S. healthcare providers, ensuring timely follow-up with insurance companies, and securing payments for outstanding claims.


Key Responsibilities

  • Contact U.S. insurance companies on behalf of physicians, clinics, and hospitals to follow up on outstanding AR.
  • Negotiate and persuade insurance payers to settle unpaid claims.
  • Apply in-depth knowledge of the U.S. healthcare domain (provider side) to drive operational improvements.
  • Demonstrate a basic understanding of Revenue Cycle Management (RCM).
  • Develop and manage collaterals as needed to support billing processes.
  • Regularly check with the Team Leader for client updates and ensure targets are met.
  • Consistently meet productivity and quality targets within turnaround times (TAT).
  • Identify issues in the process and escalate them to the Team Leader/Manager for resolution.
  • Update production logs and maintain compliance with company policies, rules, and HIPAA guidelines.
  • Follow prescribed quality processes using checklists.
  • Adhere to QMS and ISMS policies and procedures.
  • Familiarity with specialty billing, particularly in Transplant/Gift of Life/Organ Procurement billing, is a plus.

Eligibility Criteria

  • Experience: 1-3 years of relevant experience in U.S.-based AR activities on the provider side.
  • Skills:
    • Hands-on experience in analyzing and following up with insurance companies.
    • Strong oral and written communication skills.
    • Knowledge of EPIC software is desirable.
    • Ability to work on claims < $500 for follow-up and clerical denials.
    • Accounts qualify for follow-up at Day 30 from the bill date in specific work queues within EPIC.
  • Work Environment:
    • Must be open to working from the office during U.S. EST hours.

Preferred Qualifications

  • Experience in handling claims related to organ procurement and specialty billing in areas like transplant services.
  • Knowledge of healthcare compliance guidelines, particularly HIPAA.
  • Proven ability to achieve productivity and quality targets within set TATs.

Join our dynamic team to contribute to the success of physician billing and accounts receivable processes in the U.S. healthcare domain!