Accounts Receivable Analyst Ambulatory

17 hours ago

Remote, India TruBridge Full time

Accounts Receivable Analyst

  • Perform pre-call analysis and check the status by calling the payer or using IVR or web portal services.
  • Maintain adequate documentation on the client software to send the necessary documentation to insurance companies and maintain a clear audit trail for future reference.
  • Record after-call actions and perform post-call analysis for the claim follow-up.
  • Provide accurate information to the insurance company, research available documentation including authorization, physician notes, medical documentation on PM system, interpret explanation of benefits received, etc. prior to making the call.
  • Perform analysis of accounts receivable data and understand the reasons for underpayment, days in A/R, top denial reasons, use appropriate codes to be used in documentation of the reasons for denials/underpayments.
  • Comply with all reimbursement and billing procedures for regulatory, third party, and insurance compliance norms.
  • Responsible for meeting daily/weekly productivity and quality reasonable work expectations.

Responsibilities

  • Claim processing and submission.
  • Submit the claim to insurance companies to receive payment for services rendered by a healthcare provider.
  • Taking denial status from various insurance carriers
  • Checking eligibility and verification of policy
  • Analysis of the data
  • Converting denials into payments
  • Follow Health Insurance Portability and Accountability Act (HIPAA)
  • Account follow up on fresh claims, denials, and appeals.
  • Checking the claim status as per their suspension and denials
  • Achieving weekly/monthly production and audit target

Qualifications/Requirements

  • High School (HSC) or graduate or equivalent with strong analytical skills.
  • 1-3 Years of experience in accounts receivable follow-up/denial management for US healthcare.
  • Good written and verbal communication skills.
  • Knowledge of medical terminology, ICD10, CPT, and HCPC coding.
  • Basic working knowledge of computers.
  • Willingness to work continuously in night shifts.

Preferred

  • Familiar with healthcare patient billing systems (Practice management) like NextGen, eCW, Carecloud, Docutap.
  • Familiar with clearinghouse like Waystar, Realmed Availity, change healthcare, via track.
  • Proficiency with MS Excel, MS Word, google spreadsheet, etc.

Other Skills and Abilities

  • Ability to work independently with minimal supervision.
  • Good analytical skills, assertive in resolving unpaid claims.
  • Ability to multi-task and accurately process high volumes of work.
  • Strong organizational and time management skills

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