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
● Any Graduate or equivalent with strong analytical skills.
● 1+ 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
Individual Contributor
Skills Required
- Any graduate degree or equivalent
- 1+ year of experience in accounts receivable follow-up or denial management for US healthcare
- Strong analytical skills
- Good written and verbal communication skills
- Knowledge of medical terminology, ICD-10, CPT, and HCPC coding
- Basic computer skills
- Willingness to work continuous night shifts
- Familiarity with healthcare patient billing systems such as NextGen, eClinicalWorks, CareCloud, or Docutap
- Familiarity with clearinghouses such as Waystar, RealMed, Availity, Change Healthcare, or ViaTrack
- Proficiency with Microsoft Excel, Microsoft Word, or Google Sheets
- Ability to work independently with minimal supervision
- Ability to multitask and process high volumes of work accurately
- Strong organizational and time management skills
What We Do
TruBridge provides healthcare technology solutions, including electronic health records (EHR) and revenue cycle management (RCM), designed to help community and rural hospitals improve financial and clinical outcomes.
