03 Sep
|
Zenmed Solutions
|
Chennai
03 Sep
Zenmed Solutions
Chennai
Denial Analyst
:
The Denial Analyst is responsible for identifying, analysing, resolving, and preventing insurance claim denials to maximize reimbursement and protect revenue integrity. The role involves payer communication, root cause analysis, appeals preparation, and trend reporting.
The Senior Denial Analyst additionally handles complex denials, payer escalations, trend analytics, and denial prevention strategy.
JOB OBJECTIVE:
Core Responsibilities (Process Associate Denial Analyst)
1. Review and analyse denied claims (EOB/ERA).
2. Identify denial reason codes (CO, PR, OA, PI).
3. Classify denials accurately (coding, eligibility, medical necessity, timely filing, etc.).
4. Prepare and submit appeals with supporting documentation.
5. Follow up with payers via portal/phone.
6. Refile corrected claims when applicable.
7. Track appeal deadlines and ensure timely submission.
8. Document actions clearly in PM system.
9. Meet daily productivity and resolution targets.
10. Escalate complex or recurring denials to supervisor.
Charge entry
:
The Charge Entry Associate is responsible for accurate and timely entry of patient demographic details, CPT/HCPCS codes, ICD-10 diagnosis codes, modifiers, and provider information into the Practice Management (PM) system to ensure clean claim submission.
The Senior Process Associate handles complex specialty coding scenarios, quality validation, and supports process improvements to reduce front-end rejections.
JOB OBJECTIVE:
Core Responsibilities (Process Associate)
1. Enter charges accurately based on superbills, encounter forms, or EMR documentation.
2. Validate:
- Patient demographics
- Insurance details
- Rendering and billing provider details
1. Enter CPT,
HCPCS, ICD-10 codes as per documentation.
2. Apply correct modifiers (e.g., 25, 26, 59, 76, 77, etc.) when supported.
3. Verify place of service (POS) and units.
4. Ensure compliance with payer-specific rules.
5. Flag missing or unclear documentation to coding team.
6. Maintain SLA for charge entry turnaround time.
7. Ensure zero duplicate charge entry.
8. Follow HIPAA and data security protocols.
AR Analyst
:
The AR Analyst is responsible for managing outstanding insurance and patient receivables, ensuring timely follow-up, payment recovery, denial resolution coordination, and reduction of aging AR. The role focuses on improving cash flow, reducing write-offs, and identifying revenue leakage.
The Senior AR Analyst additionally handles high-value accounts, payer escalations, aging analysis, and AR performance reporting.
JOB OBJECTIVE:
Core Responsibilities (Process Associate AR Analyst)
1. Review and work on outstanding insurance claims.
2. Follow up with payers via phone and portals for claim status.
3. Identify unpaid, underpaid, or partially paid claims.
4. Coordinate with Denial team for appeal submission.
5. Identify and escalate underpayments.
6. Ensure claims are processed within timely filing limits.
7. Maintain detailed follow-up notes in PM system.
8. Work on aging buckets (030, 3160, 6190, 90+).
9. Reduce AR days and improve collection rate.
10. Adhere to SLA and productivity targets.
Walkin- 11.00 am to 3.00 pm (Monday to Friday)
Contact Details:
Contact Name: Dhanalakshmi
Contact Number: 98845 15556
Company Name: Zenmed Solution Pvt Ltd
Address:No 55, 1st floor, Seshachalam Street, Periyapet, Saidapet, Chennai, Tamil Nadu 600015.
📌 Charge Entry Specialist/AR Analyst/Denial Analyst (Chennai)
🏢 Zenmed Solutions
📍 Chennai