Senior Executive - AR caller
Responsibilities
- Investigate claim rejections or denials, identify root causes, and take corrective actions to resolve issues and resubmit claims.
- Track outstanding accounts and work to reduce aging AR through timely follow-ups
- Should met the standard quality of above 98 % and quantity of 100%
- Report to team leaders about inventories.
- Ensure adherence to healthcare regulations, payer policies, and internal guidelines to maintain the accuracy and integrity of the billing process.
Daily Routine
- Planning the day Prioritizing the tasks
- Active participation in Daily Huddles
- Handling tickets
- Need to take action for Sec Rejections/Denials
- AR Activity (Follow-up, Attention Required, No Resp, etc,.)
- Need to send EOD status to Team leader
- Need to initiate the call to the payers and obtain the required information.
Weekly Routine
- Preparing AR clarifications
- Secondary claims review Submission
- Weekly meeting with Team leader/Manager
- Weekly denials trend analysis
Monthly Routine
- Updating company scorecards
- Small Balance Adjustment
- AR Clarification/UC claims list preparation
- Redzone clients status update.
Skills and Competencies
- Basic technical skills in computer (Word Excel)
- Positive written and verbal communication skills
- Ability to explain billing issues to the supervisors clearly and professionally.
- Competency in identifying issues with claim payments or denials and finding solutions.
- Ability to track outstanding receivables and prioritize collections based on aging.
Qualifications
- Any Degree and above.
- 2+ years experience End-to-end process in RCM.
- Knowledge in our Major PMS (IMS/eCW
- Typing Skills (30 WPM with >95% Accuracy)
Key Performance Indicators (KPIs)
- Quality % ->=98%
- Quantity % (Productivity) - 100%
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