RCM AR Analyst

5 days ago

Hyderabad, Telangana, India ModMed Full time
About ModMed

ModMed is a leading provider of cloud-based healthcare technology solutions, dedicated to empowering medical practices to succeed in a rapidly changing healthcare landscape.

Job Summary

We are seeking a highly skilled and motivated RCM AR Analyst to join our team in India. As a key member of our Revenue Cycle Management team, you will be responsible for resolving claims with insurance balances that have no response or are being denied.

Key Responsibilities
  • Work assigned claims and run reports to identify claims that require follow-up and resolve denials by taking appropriate action as per ModMed guidelines.
  • Ensure timely follow-up to prevent claims from being written off due to untimely follow-up.
  • Work on contractual adjustments and write-off projects.
  • Analyze previous notes and actions taken on claims, take the correct action on claims not handled correctly previously, and bring this to the knowledge of the Quality Team.
  • Identify opportunities to improve the follow-up process and recommend changes to be added or removed in the Practice Instructions or SOPs with any recent changes at the Payer end.
  • Attend trainings to learn new updates, technologies, and techniques, enhancing knowledge of various scenarios and keeping abreast with new updates is an important requirement for this role.
  • Continuously self-audit to ensure quality standards are met.
  • Review claims thoroughly and explore all possibilities to get claims resolved prior to assigning claims to any other ModMed or client buckets.
  • Perform additional tasks or project work as assigned.
Requirements
  • 2+ years of experience as AR Follow-ups (Voice) in Physician RCM is a must.
  • Sound knowledge of working on Billing scrubbers and CH/Payer Rejections.
  • Understanding of other related functions in the RCM is required.
  • Proven experience of good Cash collected/Resolution rate.
  • Strong knowledge of Commercial & Federal payers, basic Coding concepts & CARC codes.
  • Knowledge of working and resolving Auto, WC, IPAs, etc. is required.
  • Expert in listening and resolving problems.
  • Ability to interact positively with team members, peer groups, and seniors.
  • Being proficient in delivering a high-quality outcome is a must.
  • Capable of grasping new concepts quickly; able to comprehend various training aids and process documentation.
  • Excellent written and verbal communication skills.
  • Strong knowledge of HIPAA guidelines.
  • Abide by the organization's information security policy and protect the confidentiality, integrity, and availability of all information assets.
  • Willing to work from the office in India night shift (5:30PM to 2:30AM).
Benefits
  • High growth, collaborative, transparent, fun, and award-winning culture.
  • Comprehensive benefits package including medical for you, your family, and your dependent parents.
  • The company-supported community engagement opportunities along with a paid Voluntary Time Off day to use for volunteering in your community of interest.
  • Global presence, and in-person collaboration opportunities; dog-friendly HQ (US), Hybrid office-based roles and remote availability.
  • Company-sponsored Employee Resource Groups that provide engaged and supportive communities within ModMed.

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