We are a reputable software company specializing in the healthcare industry. Since 1988 we have been servicing the healthcare industry by providing various products to laboratories, hospitals and doctors. As a member of our organization you will be joining a smart and driven team that shares your passion for exploration and discovery in the Healthcare Software vertical. Our significant investment in people, processes, and technology equips our employees with the resources and prospects to drive substantial value for all our client partners.
Roles & Responsibilities:
Eligibility Verification:
Verify patient eligibility and advantages through payer portals and insurance calls
Work on eligibility-related denials and exceptions
Handle eligibility faxes and paper claims
Review and resolve eligibility bucket scenarios
Identify and resolve insurance-related issues impacting claims
Ensure accurate insurance information to avoid future denials
Maintain and update process documents/SOPs when required
Payment Posting:
Perform ERA and EOB payment posting activities
Work on electronic and paper remittances
Handle payment posting from AR escalations
Reconcile payer portals to ensure all payments are posted accurately
Identify and report payment discrepancies and enrollment-related issues
Qualifications
Valuable understanding of US Healthcare End-to-End RCM process
Experience in Physician RCM preferred
Strong communication skills (written and verbal)
Proficiency in MS Office (Word, Excel, PowerPoint, Outlook)
Ability to work with insurance portals and payer websites
Knowledge of reporting and process metrics based on experience level
Additional Information
Transportation Faciity for Females/ Travel allowance for Males
Health Insurance and Other Benefits