Revenue Cycle Representative - AR

Process :

• Responsible for achieving the defined TAT on deliverables with the agreed Quality benchmark score.
• Responsible for analyzing an account and taking the correct action.
• Ensuring that every action to be taken should be resolution oriented whilst working on the specific task/case assigned.
• Task claims to appropriate teams where a specific department within IKS, or clients assistance is required to resolve them.

Responsible for ensuring accurate billing to the payer for a specific claim.

Addressing the clearing house and front end rejections in a timely manner within a TAT of 24 hour period

AR:

Follow up with the payors on open claims beyond a reasonable time period to identify its accurate action.

Analyze denials from insurances, verify its authenticity, understand causes and resolve them.

Ensure claims are followed up as per assigned ticklers within the stated time period.

Manage ageing on the assigned work file.

PP:

Responsible for posting the electronic payments once received from the payer onto the clients system

Responsible for posting the manual payments once received from the payer onto the clients system

Balancing the Batches / Reconciliation

Ensuring that correct balance is flipped to the patient where applicable.

Ensuring that appropriate adjustments are executed based on payor policies, client guidelines, and adhoc approvals.

EV/BV:

Responsible for reaching out to the payor to check on the insurance eligibility and the benefits of the patient

Addressing the claims to insurance or Self Pay (Patient Attention) based on the eligibility identified

Qualifications : Graduate from any discipline is a must

Role Prerequisites:

Minimum 1 year and above experience in AR, PP, Billing and EV/BV is a must.

Functional Competencies:

Knowledge of the US healthcare RCM industry would be preferred

Basic Knowledge of working on computers would be preferred

Basic Knowledge of MS Office would be preferred.

Typing Speed

Eye for Detail

Behavioral Competencies:

Team Work Communication

Customer Service Orientation Accountability

Analytical Thinking