▷ Immediate Start Senior Executive

6 days ago

Chennai India EXL Full time

Job Description JOB DESCRIPTION : RCM Denial Management - AR Caller Quality - Sr Executive JOB SUMMARY: As a QA RCM, you will be responsible for auditing the work of RCM Callers to ensure the highest standards of service delivery. Required Education/Experience - Should be Graduate - Should have worked as a Quality Controller for AR for at least one year with medical billing service providers or should have minimum 5 years experience into AR - Must have very good knowledge of medical billing and be confident in process knowledge. - Experience in the end-to-end Healthcare process and AR team for the audit - Adapting to new situation challenges whenever required. - Adhere to all company policies and procedures. Position Relationships - Reports directly to the Assistant Manager Job Responsibilities - Review the work performed by AR team and document any quality issues. - Review call quality issues on various parameters such as conversational skills, claims resolution, and voice quality. - Participate in developing process documentation. - Provide feedback and work with the training team to provide remedial training. - Check the reports developed by AR team - aging analysis, understanding days in A/R, top reasons for denials, etc - Always be at the forefront of ethical behavior and never be a bystander. Professional - Recognize and respect cultural diversity. - Adapt communication to an individual's ability to understand. - Use medical terminology appropriately. - Respond to communications received within a reasonable time frame. - Project a professional manner and image. - Adhere to ethical principles. - Demonstrate initiative and responsibility. - Work as a team member. - Efficient Time Management. - Prioritize and perform multiple tasks. - Adapt to change, including new hours of operation and methodology. - Attend functional team meetings and mandatory in-service education. - Maintain proper observation and adherence to company policies and procedures. Knowledge, Skills, And Experience - Should have worked as a Quality Controller for AR for at least one year with AR providers or should have worked more than 6 years into AR - Must have very good knowledge of AR and be confident in process knowledge. - Experience in the end-to-end Healthcare process and AR Team for the audit - Adapting to new situation challenges whenever required. - Adhere to all company policies and procedures LEGAL And COMPLIANCE - Maintain patient and company confidentiality. - Practice within the scope of education, training, and personal capabilities. - Document company documents (hard copy and electronic) accurately. - Use appropriate guidelines for releasing information. - Maintain awareness of US federal and US state health care legislation and regulations, PHI, HIPAA Working Hours - 40 hours per week as Full-time employee - Shift time: 01:30AM TO 10:30PM IST - Weekends Off Telecommuter/Internet Requirement - High Speed internet connection at home, must be broadband with minimum of 100 MBPS Speed or above - Must understand and adhere with telecommuter policy - Must have power backup at to mitigate power outage

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