Accounts Receivable Associate - RCM Only
- Bizmatics India
- 5 - 7 years
- Mumbai
- 9 months ago
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Job Description
Here at Harris, youll be working as part of 5 different business verticals, Public Sector, Healthcare, Utilities, Insurance and Private sector, with over 12,000 employees and more than 100,000 customers located in 200 countries around the globe. We need your help to keep growing and we hope you can become an integral part of the Harris family.
Job Summary:
The Account Follow-up Representative I is responsible for review and resolution of outstanding insurance balances for hospital patient accounts. The Account Follow-up Representative I is required to learn multiple hospital systems, conduct research, and work basic outstanding insurance claims in pursuit of resolving unpaid claims. The primary goal of an Account Follow-up Representative I is to complete tasks related to timely resolution of accounts receivable.
Primary Functions:
Timely follow-up on hospital patient accounts that are outstanding for insurance payment, including but not limited to the following processes: verify claim payment status, rebill to patients insurance, proration to correct financial class and notation of patient accounts with steps taken for resolution
Work an average of 30-40 patient accounts per workday for assigned payor(s)
Manages an average of 30-40 patient accounts per day, focusing on denial and zero-pay reporting.
Assigned Payor denials and Zero ($0) pay reports worked within 48 hours of receipt
Communicate effectively with insurance companies for payment of outstanding insurance balances Understanding of next steps needed to reach resolution of outstanding insurance balance
Perform research on patient accounts with outstanding insurance balances and route patient accounts through appropriate workflows
Responsible for resolving patient accounts with outstanding insurance claims to a zero balance or advancing them to the patient responsibility financial class.
Performs account follow-up on unpaid or partially paid insurance claims for hospital services.
Contacts insurance payors through various methods, including Phone calls, Insurance payor web portals E-faxing
Investigates the cause of non-payment towards outstanding hospital claims and takes appropriate actions such as: Requesting insurance companies to process claims, requesting cash posting review for corrections, Initiating coding reviews for account resolution,
Completes adjustment requests for Team Lead approval if an adjustment to the outstanding
Submits requests for claim rebilling when additional information is required, using either a spreadsheet or EHR. Uses the hospitals ticketing system to submit claim inquiry requests if additional information or review from the hospital is requiredJob Qualifications:
The qualifications we are looking for are mixture of work experience and educational background. They are split into Minimum Qualifications (must have) and Additional Qualifications (nice to have) along with soft skills (competencies) needed for the role:
Minimum Qualifications:
High School or equivalency diploma required
5-7 years experience in account follow-up role performing follow-up on hospitals inpatient and outpatient insurance claims
5-7 years experience in Customer Service positions.
Bilingual (written, verbal and listening)
Soft Skills:
Excellent communication, good judgment, tact, initiative, and resourcefulness
Must be detail oriented, organized, and ability to multi-task
Possess ability to concentrate for long periods of time
Ability to work individually and/or as part of a team
Ability to demonstrate supportive relationships with peers, clients, partners, and corporate executives
Must be flexible with a can do attitude and the ability to remain professional under high pressure situations
Demonstrates the ability to learn new systems quickly and develop proficient operating skills within a reasonably short timeframe
Must be able to follow directions and to perform work according to department standards independently
Must be emotionally mature and able to function effectively under high pressure situations
Interested candidate can share the CV at ms*****3@ha***********r.com
Job Classification
Industry: BPM / BPOFunctional Area / Department: Customer Success, Service & OperationsRole Category: Non VoiceRole: Non Voice - OtherEmployement Type: Full timeContact Details:
Company: Bizmatics IndiaLocation(s): Mumbai
Keyskills: Hospital Claims RCM US Healthcare Denial Management
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