We are hiring for one of the US Healthcare company name AGS Heathcare, They are basically hiring for a Voice Helathcare process.
Job DescriptionROLE & RESPONSIBILITIES
As an AR Associate your role will be to:
4 Resolve outstanding facility/physician AR through reviewing the denial posted on the service billed, follow up transactions done post the denial being posted, identify the root cause for the denial and then take corrective actions to resolve the claim. Key responsibilities include:
4 Address and resolve AR inventory assigned while adhering to client specifics, payer specifics and compliant with State and Federal rules and the organization’s Acceptable Usage policy
4 Utilize web-based payer resources or phone calls to the payer to identify the root cause for non-payment/delayed adjudication and take corrective action. Corrective action will include: o Claim resubmission for claims not on file or post identifying the appropriate to be billed
o Corrected claim resubmission post verification of benefits/charge corrections.
o Resolve rejection edits and resubmit the claim
o Submission of additional documentation to enable adjudication of the claim as requested by the payer
o Submit appeals contesting the reason provided for denying the service rendered with justification for the appeal, with supporting documentation being submitted
o Determine the next responsible payer post adjudication of the claim and transfer balance after determining that the payer has adjudicated as per client contract and contractual allowance taken
o Recommend timely filing or Appeal limit exceeded claims for write-off/adjustment
4 Concise documentation of review done, action taken on the claim, along with appropriate tracking stamps like claim #, call reference # along with worked date and initials
4 Identify and escalate trends that is impacting resolution of claims submitted to a payer and suggest solutions to submit a clean claim
4Follow up on claims resubmitted/appeals submitted post providing adequate time for payer adjudication/reconsideration
Qualifications
ACADEMIC AND PROFESSIONAL BACKGROUND
4 University graduate with an average aptitude score
412 months – 4 years of Physician/Facility AR follow-up experience
4CRCE/CRCP/CRCS certification will be an added advantage
Additional InformationCOMPETENCIES, SKILLS AND OTHER REQUISITES
4Good analytical ability
4Logical thought process
4Attention to detail
4Fair domain expertise and exposure to different billing applications
4Good communication skills – Listening, Verbal and Written
COMPENSATION AND BENEFITS - Competitive remuneration + annual performance-based bonus + standard industry benefits. Relocation package, per company policy will apply for candidates outside the office base city.
Skills Required
- University graduate
- 12 months - 4 years of Physician/Facility AR follow-up experience
- Familiarity with web-based payer resources and phone follow-up processes
- Experience with claim resubmission, corrections, appeals, and supporting documentation submission
- Good analytical ability, logical thought process, and attention to detail
- Exposure to different billing applications and fair domain expertise
- Good communication skills (listening, verbal, written)
- CRCE/CRCP/CRCS certification
What We Do
TIM Consultants Pvt. Ltd. provides management advisory and professional business support services, including the finalization of financial statements and audit coordination. The company specializes in healthcare revenue cycle management, specifically resolving outstanding facility and physician accounts receivable (AR) through denial reviews and corrective actions for US healthcare providers to ensure efficient claim adjudication and financial recovery.
