Executive - Underpayment review

The Executive for Underpayment reviews and resolves patient accounts as per the customer guidelines. The position requires expertise in understanding provider-payer contracts in order to optimize reimbursement by initiating appropriate action.

KEY RESPONSIBILITIES:

• Identification of underpayments on patient accounts and taking appropriate action to resolve the account
• Proactively trend and monitor information to ensure that payments are posted as per contracts
• Maintain appropriate data and trends to report back collections, along with any negative collections
• Participate in weekly meetings with the customer to ensure claim denials trends are discussed
• Comply with all reimbursement and billing procedures for regulatory, third party, and insurance compliance norms
• Provide daily reports as assigned including but not limited to: Claim error report, Audit report, Payment Variance
• Work closely with Accounts Receivables Team to resolve account or payer issues, including identifying if underpayment or overpayment issue is related to payor, incorrect insurance, or billing error.
• Work with the contracts team to update contract loading issues so that the correct expected reimbursement is reflected upon pricing of the claim
• Identifies payer problems that relate to billing or collections.
• Participates in Performance Improvement activities.

To be considered for this position, applicants need to meet the following qualification criteria:

• 2-4 years of experience in accounts receivables management
• Good understanding of collections processes and managed care contracts
• Ability to read and understand complex contract terms and the ability to communicate and/or resolve the deficiencies with both internal and external customers.
• Strong Mathematical and Analytical Skills
• Graduate Degree in any steam
• Excellent communication skills, both written and verbal.
• Must be flexible to work in shifts
• Freshers with good typing and communication skill may also apply