The BR Analyst is responsible for accurate and timely processing of healthcare claims, identifying and resolving rejected or denied claims, and ensuring compliance with billing standards. This role involves monitoring billing queues, performing edits, analyzing rejection patterns, and collaborating with internal and external teams to optimize revenue cycle performance. The Analyst will play a key role in minimizing financial leakage, maintaining billing accuracy, and supporting operational efficiency.

Essential Functions: In addition to working as prescribed in our Performance Factors specific responsibilities of this role include:
• Process claims in Customer Service (CS) queues, perform edits, and manage unbilled items to ensure timely submission.
• Review and analyze rejected or denied claims, identify root causes, and implement corrective actions.
• Maintain explicit and accurate documentation of billing activities, including system notes and audit trails.
• Collaborate with internal teams and payers to resolve billing issues efficiently.




• Monitor trends in claim rejections and provide feedback for process improvements.
• Ensure compliance with all billing, reimbursement, and regulatory requirements (including HIPAA).
• Meet or exceed daily/weekly productivity and quality targets.

All activities must be in compliance with Equal Employment Opportunity laws, HIPAA, ERISA, and other applicable regulations.

Key Result Areas (KRAs)
Category
Target
Weightage
Remarks
Production
≥ 100%
40%
Regular CS queues, edits, unbilled items
Quality
≥ 98.5%
40%
Achieve your set target on a monthly basis
Follow SOPs and Checklists
≥ 95%
10%
Follow SOPs, Site Books, and Checklists
Time on System
9 hrs daily
4%
Meet required 9 hrs time-on-system mandate (only 3 days non-adherence allowed)
Shift Adherence
Login before shift time
3%
Meet required shift start/end mandate (only 2 days non-adherence allowed)
Unapproved Leaves
0
3%
Associate should not take any unapproved leaves

Minimum R

📌 Billing & Rejections Analyst (Chennai)
🏢 CPSI
📍 Chennai