RCM Denial Management

3 weeks ago

delhi, India EXL Full time
JOB SUMMARY: As a Lead Assistance Manager for the AR Process within our Revenue Cycle Management department, you will lead a team of AR specialists responsible for analyzing and resolving claim denials to maximize revenue and minimize revenue leakage. This role plays a pivotal part in ensuring efficient, effective and improving cash flow, and optimizing the revenue cycle.
Essential Duties and Responsibilities
Establishes and assures compliance with departmental policies and procedures in conformance with corporate policies and procedures.
a) Day-to-day operational activities.
b) People Management (Work Allocation, On job support, Feedback & Team building)
c) Performance Management (Productivity, Quality, One-On-One sessions, KRA, PIP)
d) Monitoring overall productivity and implementing new strategies for increasing efficiency.
e) Reports (Internal and Client performance reports)
f) Work allocation strategy
g) HST PMS, Waystar/Payer Path Clearing House, payer (insurance) portal and Professional Billing AR experience is mandatory (Urology Specialty will have added advantage but not mandatory)
h) Span of control – 20-50
i) Thorough knowledge of all AR scenarios and Denials
j) Expertise in both Federal and Commercial payor mix
k) Excellent interpersonal skills
l) Should be capable to interact with US clients and manage escalations
m) Should have hands on experience in AR function (both AR Analyst and AR Caller). Should be able to dig in deep in account level and clog in any AR issues that may arise over time and period.
Qualifications
Graduate in any discipline from a recognized educational institute
Good analytical skills and proficiency with MS Word, Excel and PowerPoint (Typing speed of 30 WPM)
Good communication Skills (both written & verbal)
Should be comfortable in working in India Night Shift
Work model will be Hybrid- Majority WFH and few cases WFO.
Should have HIGH SPEED Internet connection (BROADBAND setup) at home with 200 MBPS or speed.
Should have power backup facility at home for continuous work without disruption.
Skill Set
Should have minimum of 8+ Years of experience working in AR function (professional billing) in any RCM company in India.
Should have currently Assistant Manager experience in PAPER for minimum of 2 Years. 4 years of managing/handling experience in AR functions (managing both AR Analyst and AR Callers) is mandatory.
Candidate should be good in Denial Management
Candidate should have knowledge of Medicare, Medicaid & ICD & CPT codes used on Denials
Ability to interact positively with team members, peer group and seniors. Should be able to drive and manage team PAN India remotely .
Demonstrated ability to exceed performance targets
Ability to effectively prioritize individual and team responsibilities
Communicates well in front of groups, both large and small.

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