Managed Medicaid Collector

3 weeks ago

India HealthRecon Connect Full time

Full Time
- India
- Posted 3 months ago

HealthRecon Connect provides technology-enabled Revenue Cycle Management solutions to US healthcare providers. The company leverages over 30 years of deep domain expertise, machine learning, AI, cutting-edge analytics, and automated workflows that help improve cash flow, patient outcomes and enable peace of mind for their clients. At HealthRecon Connect, day after day, we not only hold ourselves accountable for setting and maintaining high standards, but we also passionately strive for the highest achievement, customer delight and thrive on the challenge of high expectations and commitment to excel.

HealthRecon was certified a Great Workplace by Great Place to Work® Sri Lanka since 2018 and was adjudged one of the 40 Best Workplaces in Sri Lanka by Great Place to Work® Sri Lanka in 2021. We are also a Signatory Participant of the United Nations Global Compact.

We are looking for Managed Medicaid Collector (Senior Operations Analyst/ Specialist) to join our team. Please review the criteria and other information listed below thoroughly prior to applying. Please pay specific attention to the work week, shift details and other features of the job.

**Job Vacancy**:
Managed Medicaid Collector (Senior Operations Analyst/ Specialist)

**Work Week**:
Monday to Friday

**Shift**:
7.30pm to 4.00am India Standard Time (Night Shift)

In the best interest of the health and safety of our team and their loved ones, HealthRecon Connects work-from-home policy is currently in full effect. Unless otherwise instructed, you will be required to work from home until further notice.

**Other Features**:
Full-time
US calendar applicable

**Responsibilities**:

- Responsible for following up on pending Account Receivable in accordance with the specific payer guidelines, policies, procedures, and compliance regulations for Medicare & Medicaid.
- Carry out AR follow up efficiently according to the daily production targets specified.
- Generate 30 plus AR reports, analyze and work based on priority levels.
- Review and manage Accounts Receivables for Medicaid Managed Care plans.
- Contact Medicaid Managed Care plans to follow up on outstanding claims and appeals.
- Update Medicaid policies and procedures, and incorporate them into daily activities.
- Ensure proper analysis is done before reaching out to insurance representatives and resolve internal gaps.
- Develop AR and Root Cause analysis and share with management for review.
- Ensure 30+ aged AR paid rate is achieved as expected.
- Act as the point of contact for assigned client for internal and external queries.
- Ensure QA reports are reviewed, fixed and responded back to the QA teams within 24 hours.
- Enforce company regulatory standards to ensure the area of responsibility is in compliance with HIPPA and ISO standards.
- Share Daily and Weekly assigned reports within given timelines.
- Update SOPs in a timely manner and according to the required level.
- Conduct training to newcomers on the job specific functions.

**Qualifications/Criteria**:

- At least 2 years of hospital revenue cycle experience.
- Exposure to Federal/Managed Care rules, regulations, and coverage guidelines.
- Expert-level knowledge of MCO & CMC Plans and carriers.
- Knowledge in State level Managed Care plans & Hospital reimbursement policies.
- Diploma/ bachelor’s degree in finance, Healthcare, Business, or related field would be advantageous.
- Hospital AR experience with Managed care, Medicare/Medicaid experience.
- Hands on experience in Cerner practice management system.
- Proven expertise in Accounts Receivables management on Provider RCM.
- Ability to work with MS Office package.

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