Revenue Cycle Representative_AR

Key Responsibilities:

Process:

● Responsible for achieving the defined TAT on deliverables with the agreed Quality benchmark score. ● Responsible for analyzing an account and taking the correct action.

● Ensuring that every action to be taken should be resolution oriented whilst working on the specific task/case assigned.

● Task claims to appropriate teams where a specific department within IKS, or client's assistance is required to resolve them.

Billing:

● Responsible for ensuring accurate billing to the payer for a specific claim.

● Addressing the clearing house and front end rejections in a timely manner within a TAT of 24 hour period

AR:

● Follow up with the payors on open claims beyond a reasonable time period to identify it's accurate action.

● Analyze denials from insurances, verify its authenticity, understand causes and resolve them.

● Ensure claims are followed up as per assigned ticklers within the stated time period.

● Manage ageing on the assigned work file.

PP:

● Responsible for posting the electronic payments once received from the payer onto the client's system

● Responsible for posting the manual payments once received from the payer onto the client's system

● Balancing the Batches / Reconciliation

● Ensuring that correct balance is flipped to the patient where applicable.

● Ensuring that appropriate adjustments are executed based on payor policies, client guidelines, and adhoc approvals.

EV/BV:

● Responsible for reaching out to the payor to check on the insurance eligibility and the benefits of the patient

● Addressing the claims to insurance or Self Pay (Patient Attention) based on the eligibility identified

Qualifications:  Graduate from any discipline is a must

Role Prerequisites:

● Minimum 1 year and above experience in AR, PP, Billing and EV/BV is a must.

Functional Competencies:

● Knowledge of the US healthcare RCM industry would be preferred

● Basic Knowledge of working on computers would be preferred

● Basic Knowledge of MS Office would be preferred.

● Typing Speed

● Eye for Detail

Behavioral Competencies:

● Team Work ● Communication

● Customer Service Orientation ● Accountability

● Analytical Thinking

* Please note: The competencies highlighted above under the functional and behavioral competencies are the MUST HAVE competencies in the role and need to be mandatorily measured during the assessments OR hiring process