Accounts Receivable Caller

2 weeks ago

Chennai, Tamil Nadu, India R1 RCM Full time ₹ 9,00,000 - ₹ 12,00,000 per year

Job Description Underpayment Validation - HB

Who we are:

R1 RCM is a leading provider of revenue cycle services and physician advisory services to healthcare providers. We help transform and manage the commercial infrastructure of care organizations.

What you will do:

  • Study and analyze the healthcare reimbursement models to ensure the revenue estimation is in-line with the contracts.
  • Diagnose and understand how the underpayment occurred and what our client could have done to prevent it.
  • Work on financial analysis, reviews, and deep dives on client specific healthcare data, making sure of accuracy of revenue projections and actual collections.
  • To call payors for underpaid charges and get status to provide correct resolution for claims for underpayment and denials.
  • To perform various analytical reviews and deep-dives (root cause analysis) on client-specific for underpayment validation and find out better way to manage calls and target simultaneously.
  • Identify the reason of variance by applying all healthcare reimbursement methodology.
  • Find out the status of appeals/claims through various web payor portals.
  • To effectively communicate the findings/ observations with recommended action to US team/clients.
  • Handling client calls and communicating effectively for task deliverables and inventory/workflow management/overdue claims management.
  • Maintaining quality for each claim and provide proper comments for observations.
  • Should have good understanding of notes interpretation.

What will you need:

  • Graduate degree Preferably from a reputed educational institute
  • Underpayment experience and knowledge
  • Payer contract building experience and expected reimbursement expert with EOB knowledge.
  • AR follow-up (this role does not translate 100%. In addition to calling on denials, the employee needs to be able to analyze why an account was underpaid and pursue the underpayment using various methods)
  • Good calling and analytical skills, call time management is key factor to manage payor calls.
  • Skills to read, understand and interpret EOB, UB/itemized bills, denial letters, appeal letter and SOPs
  • Experience/knowledge of various US healthcare payors, payor portal (like Availity tool), payor websites etc.
  • Excellent Communication Skills, hands on payor calling experience.
  • Preferable - 2-3 years of Experience of Underpayment validation, if not available then trainable resources from (AR follow up, contract modeling in US healthcare)
  • Having good knowledge about RCM cycle and denial management
  • Open to work in EST/PST time zone as per process requirement.

If you are interested , share your resume to the below contact details.

HR - Ramya

Mail -

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