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.

Billing:

• 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