Process Associate

3 days ago

Mohali, India i3synergist Full time

**This is a work from office position only.**
- Maximize insurance reimbursement for providers Must have work experience of Physician Billing process.
- Discover root causes for medical insurance claim denial, underpayment, or delay and propose resolutions.
- Interact with the US-based insurance carriers to follow-up on submitted claims, monitor unpaid claims, delayed processing, and underpayment plan, and execute medical insurance claim denial appeal process.
- Must have work experience in Personal Injury and Workers Comp AR. Comfortable talking to attorney and adjustors.
- Must be proficient in denial management and appeal process.
- Must have excellent documentation skills for maintaining SOPs/guidelines/notes.
- Review EOB/ERA denials and Patient history notes to understand and resolve denial on a claim.
- Interact with US-based practice owners and clinicians on completing and correcting any missing or incorrect data on their insurance claims. Must be comfortable in AR calling and have relevant experience.
- Identify claims that need balance transfer to patient and secondary balances or appropriate financial class for further resolution.
- Should be able to track and follow up on claims within given TAT.
- Must be comfortable with other voice process as per business requirement such as patient calling.
- Completed graduation. Other formal education or training on a practice management system using patient accounting will be added advantage.
- Relevant experience in a USA health care medical billing or RCM office capacity with related job duties and responsibilities.
- Must have at least 1+ yrs. experience in physician billing; specifically, chiropractic, mental health, behavioral health etc.
- Understand CMS-1500 and UB-04 claim formats.
- Basic knowledge of collection laws, rules, and regulations.
- Knowledge of medical billing software, preferably Tebra, Therapy Notes, Simple Practice, Theranest, ECW, Epic or any other similar.
- Experience reading and interpreting and entering insurance EOBs. Knowledge of third-party payer referral requirements.

**Competencies**:

- Excellent verbal and written English communication skills for interacting with USA based team members/ physicians/vendors/patients.
- Professional and able to make a great impression on the phone. Required to understand, communicate & work regularly with USA based team.
- Positive attitude and able to follow directions.
- Ability to work well with others and facilitate teamwork and cooperation.
- Willing to cross train and cross learn other areas of RCM.
- Tact, diplomacy, and the ability to maintain confidentiality of company, client and patient information.
- Must have very strong work ethic and excellent attention to detail.
- Able to manage data in spreadsheets and CRM.
- Prepare and analyze MIS reports for management review.

**Job Types**: Full-time, Permanent

**Salary**: ₹20,000.00 - ₹35,000.00 per month

**Benefits**:

- Health insurance
- Provident Fund

Schedule:

- Evening shift
- Monday to Friday
- Night shift
- US shift

**Experience**:

- AR: 2 years (required)

**Language**:

- fluent english (required)

Shift availability:

- Night Shift (required)
- Overnight Shift (required)

Work Location: In person

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