Ensure quality driven follow-up activities and resolution of accounts is carried out with the insurance carriers on the outstanding inventory to yield maximum cash flow and minimum bad debts
Interact by Phone and Internet based portals with the insurance companies in US to procure status of the claim followed by appropriate activities to address open AR
The key functions of an AR Executive are to ensure the below responsibilities are carried out to the best of his/her ability in the interest of the organization and client
RESPONSIBILITIES
To address outstanding or assigned AR through analysis and phone calls by using available resources
Utilization of all possible tools and applications available to take account to the next level of resolution, which would result in a payment, corrected submission, appeals, patient transfer or adjustment
To report trends / patterns in denials, claim submission errors, credentialing issues and billing related roadblocks to the immediate reporting manager.
To meet the established SLAs (service level agreements) for production and quality
To update the outcome of the calls or analysis in a clear and coherent manner in the billing system
To utilize the P & P s (policies and procedures) established for the process and stay updated with changes done with the P & Ps
To improve the performance based on the feedback provided by the reporting manager / quality audit team
COMPLIANCE
Awareness and adherence to all applicable organization wide policies and procedures, including but not limited to Information security, HIPAA, and HR policies.
ACADEMIC AND PROFESSIONAL BACKGROUND
University graduate with an average aptitude score
Minimum 12 months - 4 years of AR follow-up experience with either physician or hospital billing background
CPAT/CCAT certification will be an added advantage
COMPETENCIES, SKILLS, AND OTHER REQUISITES
Sound analytical skills
Logical thinking
Attention to detail
Adequate domain knowledge on various billing terminologies & processes