Job Title

Job descriptionKey Responsibilities for AR: Review account thoroughly, including any prior comments on the account, EOBs / ERAs / Correspondence, and perform pre-resolution analysis. Understand the reason for rejection, denials, or no status from the payer. Work on the resolution of the claim by performing follow-up with the payer using the most optimal method, i.e., calling, IVR, web, or email. Take appropriate action to move the account towards resolution, including rebilling the claim, sending claims for reprocessing, reconsideration, redetermination, appeal (portal/web, fax, mail), verifying eligibility and benefits, and managing management hand-off with the client and internal teams. Documentation of all the actions on the practice management system and workflow management system, and maintain an audit trail. Ensure adherence to Standard Operating Procedures and compliance. Highlight any global trend/pattern and issue escalation with the leadership team. Meet the productivity and quality target on a daily/monthly basis. Upskill by learning new/additional skills and enhancing competencies. Active participation in all process/client-specific training and refresher training. Requirements: Undergraduate / Graduate in any stream with 2 to 4 years of experience in US Healthcare RCM for Account Receivable / Denial Management Resolution. Fluent communication, both verbal and written. Good analytical skills, attention to detail, and resolution-oriented. Should have knowledge about the RCM end-to-end cycle and proficiency in AR fundamentals and denial management. Basic knowledge of computers and MS Office.