RCM Associate

19 hours ago

India EMPClaims Full time

About company EMPClaims was recently recognized as a Top 10 vendor for RCM Services in the US, and we take pride in the quality of our services. Our customers include large health systems and small medical practices. We offer you a competitive compensation package along with the opportunity to learn on the job, develop knowledge of the process, and grow your career. - AR Analyst Roles and Responsibilities - Review the Claim status & update accordingly via Calls - Communicate effectively, via phone and email - Evaluation of clinical documentation. - Follow the Patient Claim Plans Required Qualifications & Skills: - Excellent verbal & written communication & listening skills. - Requires working knowledge of MS Office (Excel, Word) - Good Understanding of the US accent - Should be open for fixed night shift (06:00 PM to 03:00 AM) - Payment Posting Analyst The Payment Posting Analyst will be responsible for accurately posting and reconciling payments, adjustments, and denials received from various payers. The ideal candidate should have a strong understanding of ERA/EOB posting, payment reconciliation, and patient statement management. Key Responsibilities - Accurately post and reconcile payments from insurance companies, patients, and government payers (ERA/EOB). - Verify payment amounts, adjustments, and denials as per payer remitance advice. - Enter payment data into the billing system and ensure timely, error-free posting. - Review and analyze EOBs and ERAs to identify discrepancies, underpayments, or overpayments. - Investigate and resolve payment discrepancies or posting errors promptly. - Work with the denial management team to resolve claim denials and ensure accurate reimbursement. - Perform daily and monthly reconciliations of posted payments with bank deposits. - Generate and manage patient statements and ensure accurate account balances. - Identify and report any irregularities or variances in cash reconciliation. - Billing Analyst Job Description We are seeking an experienced Medical Billing Associate with a strong understanding of end-to-end US healthcare billing processes. The role requires attention to detail, analytical skills, and a solid understanding of payer policies and claims management. Key Responsibilities - Prepare, review, and submit accurate medical claims to insurance companies electronically and manually. - Monitor and follow up on unpaid or delayed claims within the standard billing cycle timeframe. - Correct and re-submit rejected or denied claims after verifying and resolving issues with payers. - Work with the coding team to ensure accurate CPT, ICD, and modifier usage before claim submission. - Maintain detailed records of all billing and payment activities in the billing system. - Identify billing errors, underpayments, or trends affecting reimbursement and escalate as needed. - Stay current with payer guidelines, insurance policies, and updates in medical billing codes. - Ensure strict adherence to HIPAA compliance and patient data confidentiality. - Coordinate with AR, Payment Posting, and Credentialing teams for smooth end-to-end RCM flow. - Meet or exceed productivity and accuracy targets as defined by management. - Participate in process improvement initiatives to optimize claim turnaround and reduce denials.

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