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Senior Executive EXL/SE/1001084

5 months ago

Chennai, India exl Full time

Job Description

Overview:

Deliver Daily targets for payment posting transactions. (ERA & Manual EOB Posting)

Qualifications:

Graduation in any stream (Preferred science and math background)

Experience:

BPO Experience – 2-5 years 

US Healthcare Payment posting experience preferred.

Communication Skill: 

Strong written (documentation) and oral communication skills

Working Hours:

40 hours per week as Full-time employee

Shift time: Day/Mid Shift

Weekends Off

Telecommuter/Internet requirements, if applicable:

High Speed internet connection at home, must be broadband.

Must understand and adhere with telecommuter policy.

Skills and abilities: Ensure Daily Productivity targets are met at the required quality level on the assigned inventory Perform accurate payment posting. Process all ERA & Manual EOB’s and reconcile daily/monthly reports for review. Process payments in Practice Management System (PMS) as per instructions provided by the client. Review and update the patient insurance information in the Practice Management System (PMS) Good understanding of downloading the files from the FTP / document management system. Strong in reviewing EOB'S and trained in posting both Manual and ERA ( Remits) Should have knowledge to identify denial codes (RARC & CARC) with denial reason & Correspondence. Should have knowledge in patients’ payment posting, Offset and Refund, “Small Balance Write Off.” Should have knowledge in Recoupment and Over Payment/Under Payments, Sequestration and Interest payment/Penalty payments. Should have knowledge in Cross Over (Piggy Bag), Capitation Agreement Payments Knowledge about Patient’s Responsibility (Copay, Coinsurance & Deductible) Knowledge about the Participating and Non-Participating Provider. Good understanding on HSA and HRA payments, “Worker’s Comp” and “No Fault” User to be proactive in escalating to his supervisor on any new scenarios/ challenges identified in the process. Tracking and drafting clarifications clean and clear Have hands on experience with basic excels, strong analytical skills. Flexible as per project and client requirements and good team player Readiness for extending shift during month end processing. Resources should be from Chennai only (physical location should be Chennai). Willing to work from the office as and when required. Initial 1 month or 2 work from Chennai office mandatory. Require resources for Band A1 and A2. Experience criteria- 3-5 years, need productive resource for the next 3 years. Hands on experience in NextGen PMS, should be aware of end of end payment posting, managing, and tallying from deposit log. Should have hand-on understanding of posting $0 remits and denials in the NextGen PMS.Should have hands-on experience working correspondence and postings. Understands all the denials scenarios and interpretation of denial codes in the correspondence/$0 remits.

Acknowledgement (acknowledge that the information contained in this document is factual and complete)

Created by: 

Designation: Date: MM/DD/YYYY

Criteria and Clause:

Resource should be from Chennai only (physical location should be Chennai). Willing to work from office as and when required. Initial 1 month or 2 work from Chennai office mandatory. Experience criteria- 3-5 years, need productive resource for the next 3 years. Hands on experience in NextGen PMS, should be aware of end of end payment posting, managing and tallying from deposit log. Should have hand-on understanding of posting $0 remits and denials in the NextGen PMS.Should have hands-on experience working correspondence and postings.Understands all the denials scenarios and interpretation of denial codes in the correspondence/$0 remits.