Healthcare Finance Operations Specialist

3 weeks ago

Hyderabad, Telangana, India myGwork Full time

Company Overview

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At Amazon, we are committed to building a diverse and inclusive workplace that reflects the communities we serve. Our mission is to provide operations accounting and operations excellence services with the highest level of controllership at the lowest cost to the company.

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About myGwork

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myGwork is an inclusive employer and a member of the LGBTQ+ business community. We believe in creating a workplace where everyone feels valued, respected, and empowered to be their authentic selves.

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Job Summary

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We are seeking a skilled Healthcare Finance Operations Specialist to join our team at Amazon. This role will involve working with talented and determined people committed to driving financial improvement, scalability, and process excellence in the healthcare industry.

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Key Responsibilities

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•Claims Processing: Reviewing and investigating claims processing, verifying the proper payment of claims, and bringing insurance claims to full resolution through a combination of external third-party relationships and cross-functional communication and collaboration.

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•Service Level Agreements: Maintaining service level agreements regarding assigned accounts receivable tasks while ensuring timely resolution of all claims while prioritizing responsibilities, problem solving, and thinking critically as you perform your regular duties and accommodate other time-sensitive tasks as they arise.

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•Accounts Receivables Management: Conducts regular review and follow-up of accounts receivables, ensuring the timely resolution and payment of accounts. Utilizing multiple reports and worklists, ensuring that all claims are adjudicated correctly per the member's benefits, investigating claims that do not process as expected or for which we do not receive a determination, all while adhering to all applicable guidelines.

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•Process Improvement: Design, develop, and implement process improvements to prevent denials and reduce internal processing errors.

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•Training and Development: Developing resource material that is accessible and shared by the team and assist in the development of training materials for denial management. Assist in the training of new hires in AR.

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BASIC QUALIFICATIONS:

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•Bachelor's Degree: Bachelor's degree in finance, accounting or related field.

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•Experience: Minimum experience of 4 years in Insurance Accounts Receivable in RCM space required.

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•Shared Services Environment: Experience working in shared services environment with productivity targets.

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•US Healthcare Landscape: Exposure to US healthcare and insurance landscape.

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•Communication Skills: Good communication and interpersonal skills.

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•Problem-Solving: A proven track record of seeing projects through to completion, thorough follow-through, and an ability to work independently with a good attention to detail.

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•Accounting Principles: Understanding of basic accounting principles and receivables management.

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•Continuous Process Improvement: Ability to independently work with minimal support and focus on continuous process improvement.

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Salary Range

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$85,000 - $110,000 per year.

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PREFERRED QUALIFICATIONS:

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•5+ Years Experience: 5+ Years experience with US healthcare and health insurance industry.

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•Medicare Experience: Experience with Medicare preferred.

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•Primary Healthcare Setting: Prior experience of at least 2 years in Insurance Accounts Receivable in primary healthcare setting preferred.

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Project Management

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Has led or been part of a team that worked on a Six Sigma belt project / Kaizen / Lean projects.

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