- Review and analyze the assigned outstanding receivables portfolio to identify unresolved claims.
- Manage and resolve outstanding and denied claims by coordinating effectively with insurance companies.
- Follow up promptly to obtain additional information required for claim resolution.
- Ensure all claims are resolved within established timelines and adhere to defined Service Level Agreements (SLAs).
- Perform website checks and handle non-callable denials to optimize receivables recovery.
Skills and abilities:
- Working on website related claims and action based on coding team responses.
- All non-callable denials, demographic and eligibility denials need to be worked
- Ensure Daily Productivity targets are met at the required quality level on the assigned inventory.
- Perform timely follow up on claims to avoid revenue loss, Prioritize the pending claims for calling from the aging bucket
- Review claims that have not been paid by insurance companies.
- Check insurance information provided by patient if it is insufficient or unclear.
Follow the guidelines and applicable rules while calling insurance companies for confidentiality and HIPAA compliance. - Escalate difficult collection situations to management in a timely manner, Handling patients billing queries and updating their account information.
- Post cash and write off the contractual adjustments accordingly while working on the accounts.
- Meeting daily/weekly and monthly targets set for an individual.
Qualifications: Graduation in any stream
Experience: BPO Experience: 3-6 years
US Healthcare AR experience preferred
Communication Skill: Excellent written (documentation) and oral communication skill
Skills Required
- Graduation in any stream
- 3-6 years of BPO experience
- US healthcare accounts receivable experience
- Excellent written and oral communication skills
What We Do
Choosing a digital partner is about more than capabilities — it’s about collaboration and character. Unrealistic overhauls and off-the-shelf products ignore what matters most — your unique needs, culture, goals, and your legacy data and technology environments. At EXL, our collaboration is built on ongoing listening and learning to adapt our methodologies. We’re your business evolution partner—tailoring solutions that make the most of data to make better business decisions and drive more intelligence into your increasingly digital operations. Whether your goals are scaling the use of AI and digital, redesign operating models, or driving better and faster decisions, we’re here to partner with you to help you gain—and maintain—competitive advantage with efficient, sustainable models at scale. Our expertise in transformation, data science, and change management helps make your business more efficient and effective, improve customer relationships and enhance revenue growth. Instead of focusing on multi-year, resource- and time-intensive platform designs or migrations, we look deeper at your entire value chain to integrate strategies with impact. We use our specialization in analytics, digital interventions, and operations management—alongside deep industry expertise — to deliver solutions that help you outperform the competition. At EXL, it’s all about outcomes—your outcomes—and delivering success on your terms. Share your goals with us and together, we’ll optimize how you leverage data to drive your business forward. For more information, visit www.exlservice.com.
