CompuGroup Medical is a three-time consecutive Best in KLAS winner for RCM. We provide a full spectrum of Revenue Cycle Management (RCM) and BPO services. Our teams work with leading technologies and proven processes, and we invest heavily in training, development, and growth opportunities. As an innovator and leader in e-health services, we offer unparalleled opportunities to build a long-term career in the US healthcare domain.
Key Responsibilities:
As a Senior Associate in Claims Management, you will be responsible for end-to-end management of US healthcare claims and accounts receivable, serving physician practices and healthcare providers. You will play a critical role in ensuring timely reimbursement, minimizing denials, and maintaining excellent relationships with payers and patients.
Call US-based insurance companies on behalf of our clients (physicians and healthcare providers) to follow up on outstanding accounts receivable.
- Review and prioritize pending claims from the aging report for follow-up.
- Negotiate and secure payment from payers on outstanding and underpaid claims.
- Verify the accuracy and completeness of patient insurance information; resolve any unclear or inadequate details.
- Review provider claims denied or not paid by insurance companies, identify root causes, and take corrective actions.
- Escalate complex or high-risk collection issues to management in a timely and structured manner.
- Handle patient billing inquiries professionally and update patient account information as required.
- Maintain detailed and accurate documentation of all interactions and actions taken on claims.
Ideal Candidate Profile:
- Minimum 3 years of experience in US Healthcare RCM, specifically in Claims Management, Accounts Receivable, and Denials management.
- Graduate degree is mandatory.
- Willing and able to work in night shift (US time zones).
- Excellent sp