Healthcare Revenue Cycle Specialist

2 weeks ago


Mumbai, Maharashtra, India IKS Health Full time

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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