Accounts Receivable Analyst – Acute
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Job Description
Accounts Receivable Analyst performing claims processing and documentation for insurance in a remote capacity. Collaborating with healthcare providers to ensure accurate billing and follow-up.
Responsibilities:
- 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.
- 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.
Requirements:
- High School (HSC) or graduate or equivalent with strong analytical skills.
- 1-3 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.
Benefits:
- Health insurance
- Full time employment
- Remote work options
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