Senior Executive

5 days ago

Chennai Tamil Nadu, India EXL Service Full time

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 o 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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