Healthcare Revenue Cycle Specialist
2 weeks ago
About IKS Health:
We are a leading healthcare organization dedicated to delivering exceptional patient care and innovative solutions.
Salary: $65,000 - $80,000 per annum
Job Description:
Key Responsibilities:
• Achieve defined Turnaround Time (TAT) on deliverables with agreed Quality benchmark scores.
• Analyze accounts and take the correct action.
• Ensure every action is resolution-oriented while working on assigned tasks/cases.
• Task claims to appropriate teams where client assistance is required.
Billing:
• Ensure accurate billing to payers for specific claims.
• Address clearing house and front-end rejections within a TAT of one hour period.
AR:
• Follow up with payors on open claims beyond a reasonable time period.
• Analyze denials from insurances, verify authenticity, understand causes, and resolve them.
• Ensure claims are followed up as per assigned ticklers within stated time periods.
• Manage ageing on assigned work files.
PP:
• Post electronic payments received from payers onto clients' systems.
• Post manual payments received from payers onto clients' systems.
• Balance batches/reconciliation.
• Ensure correct balance is flipped to patients where applicable.
• Execute adjustments based on payer policies, client guidelines, and ad-hoc approvals.
EV/BV:
• Reach out to payors to check insurance eligibility and patient benefits.
• Address claims to insurance or Self-Pay (Patient Attention) based on identified eligibility.
Qualifications:
A graduate from any discipline is mandatory.
Role Prerequisites:
• Minimum one year and above experience in AR, PP, Billing, and EV/BV is mandatory.
Functional Competencies:
• Knowledge of the US healthcare RCM industry would be preferred.
• Basic knowledge of working on computers would be preferred.
• Basic knowledge of MS Office would be preferred.
• Typing speed.
• Eye for detail.
Behavioral Competencies:
• Teamwork.
• Communication.
• Customer Service Orientation.
• Accountability.
• Analytical Thinking.
About You:
To excel in this role, you should have strong analytical skills, attention to detail, and excellent communication skills. You should also be able to work effectively in a team environment and have a customer-centric approach.
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