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Revenue Cycle Representative_AR

Revenue Cycle Representative_AR

IKS Healthmumbai, India
30+ days ago
Job description

Key Responsibilities :

Process :

  • Responsible for achieving the defined TAT on deliverables with the agreed Quality benchmark score.
  • Responsible for analyzing an account and taking the correct action.
  • Ensuring that every action to be taken should be resolution oriented whilst working on the specific task / case assigned.
  • Task claims to appropriate teams where a specific department within IKS, or client's assistance is required to resolve them.

Billing :

  • Responsible for ensuring accurate billing to the payer for a specific claim.
  • Addressing the clearing house and front end rejections in a timely manner within a TAT of hour period
  • AR :

  • Follow up with the payors on open claims beyond a reasonable time period to identify it's accurate action.
  • Analyze denials from insurances, verify its authenticity, understand causes and resolve them.
  • Ensure claims are followed up as per assigned ticklers within the stated time period.
  • Manage ageing on the assigned work file.
  • PP :

  • Responsible for posting the electronic payments once received from the payer onto the client's system
  • Responsible for posting the manual payments once received from the payer onto the client's system
  • Balancing the Batches / Reconciliation
  • Ensuring that correct balance is flipped to the patient where applicable.
  • Ensuring that appropriate adjustments are executed based on payor policies, client guidelines, and adhoc approvals.
  • EV / BV :

  • Responsible for reaching out to the payor to check on the insurance eligibility and the benefits of the patient
  • Addressing the claims to insurance or Self Pay (Patient Attention) based on the eligibility identified
  • Qualifications : Graduate from any discipline is a must

    Role Prerequisites :

  • Minimum year and above experience in AR, PP, Billing and EV / BV is a must.
  • Functional Competencies :

  • Knowledge of the US healthcare RCM industry would be preferred
  • Basic Knowledge of working on computers would be preferred
  • Basic Knowledge of MS Office would be preferred.
  • Typing Speed
  • Eye for Detail
  • Behavioral Competencies :

  • Team Work
  • Communication
  • Customer Service Orientation
  • Accountability
  • Analytical Thinking
  • Please note : The competencies highlighted above under the functional and behavioral competencies are the MUST HAVE competencies in the role and need to be mandatorily measured during the assessments OR hiring process

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    Revenue • mumbai, India

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