Process Associate -Accounts Receivables (US Healthcare)

JOB DESCRIPTION

Designation/ Role:    Process Associate/ Sr Process Associate

Department:               Accounts Receivable

Work Timing:              Night Shift

Qualifications:            Minimum HSC/10+2 Equivalent (Any Graduate Preferred)

Skills:

A successful candidate must have proficient knowledge/capabilities in the following areas:

1. Claims management and/or customer service experience desired.


2. Bachelor’s degree preferred, or any equivalent combination of education and experience.


3. Ability to perform at a high level of productivity and quality.


4. Capacity to maintain a high level of accuracy.


5. Excellent written and oral communication skills required to represent  Clients.


6. Computer skills including Microsoft Office Suite.


7. Skills to work independently and be resourceful with the ability to multitask.

Experience

1–3 years’ experience US calling process.

Job Description

The job involves an analysis of receivables due from healthcare insurance companies and initiation of necessary follow-up actions to get reimbursed. This will include a combination of voice and non-voice follow-up along with undertaking appropriate denial and appeal management protocol.

Job Responsibilities

A successful candidate will perform the following activities:

1. Review patient accounts and perform appropriate follow up actions to resolve the outstanding balance according to best practice standards.


2. Complete and send appropriate claim forms according to CMS and third-party payor guidelines.


3. Follow up with medical insurance payors regarding the status of outstanding claims.


4. Contact patients and guarantors regarding outstanding self-pay balances due.


5. Compose correspondence to insurance payors, third parties, and patients regarding the resolution of outstanding balances and claim appeals.


6. Document all actions taken in appropriate  or Client host system.


7. Adhere to HIPAA, patient confidentiality and compliance requirements at all times.


8. Research payor rules and regulations to maintain current payor knowledge.


9. Demonstrate service excellence to all patients, clients, and employees of .


10. Meet individual and team goals for productivity, quality and results to Clients.

 "All candidates and employees must consistently comply with 's Information Security policy."