Manage insurance claim follow-ups and collections, ensure daily productivity and quality targets, resolve patient billing queries, post payments and adjustments, maintain HIPAA compliance, and use practice management/EMR systems to prevent revenue loss.
PROFESSIONAL:
- Recognize and respect cultural diversity.
- Adapt communication to an individual’s ability to understand. • Use medical terminology appropriately.
- Respond to communications received within a reasonable time frame.
- Project a professional manner and image.
- Adhere to ethical principles.
- Demonstrate initiative and responsibility.
- Work as a team member.
- Efficient Time Management.
- Prioritize and perform multiple tasks.
- Adapt to change, including new hours of operation and methodology.
- Attend functional team meetings and mandatory in-service education.
- Maintain proper observation and adherence to company policies and procedures.
- Interact and probe the insurance representative to get the required status update and have the claim resolved
- 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
- REQUIRED EDUCATION/EXPERIENCE: Graduate in any stream; customer service; must be computer literate; have multi-tasking skills, excellent organizational skills, verbal and written communication skills; team player.
YEARS OF EXPERIENCE:
- 2-5 Years for A2 Band
POSITION RELATIONSHIPS:
- Reports directly to the Assistant Manager
KNOWLEDGE, SKILLS, AND EXPERIENCE:
- Good organizational skills and the ability to multi-task
- Ability to operate basic office equipment, answer multi-line telephones, and have a strong computer background.
- Establish and maintain effective working relationships with patients, insurance companies, and staff.
- Good written and oral communications.
- Knowledge and skills in working with computerized billing systems including practice management software and EMR.
- Must adhere to all HIPAA guidelines and regulations.
- Knowledge of medical insurance and authorization processes.
- Some medical terminology and experience working in a healthcare or insurance environment.
LEGAL and COMPLIANCE:
- Maintain patient and company confidentiality.
- Practice within the scope of education, training, and personal capabilities.
- Document company documents (hard copy and electronic) accurately.
- Use appropriate guidelines for releasing information.
- Maintain awareness of US federal and US state health care legislation and regulations, PHI, HIPAA
WORKING HOURS:
- 40 hours per week as Full-time employee
- Shift time: 7:30 PM IST - 4:30 AM IST
- Weekends Off
TELECOMMUTER/INTERNET REQUIREMENT:
- High Speed internet connection at home, must be broadband with minimum of 100 MBPS Speed or above
- Must understand and adhere with telecommuter policy
- Must have power backup at to mitigate power outage
EXL (NASDAQ: EXLS) is a leading data analytics and digital operations and solutions company. We partner with clients using a data and AI-led approach to reinvent business models, drive better business outcomes and unlock growth with speed. EXL harnesses the power of data, analytics, AI, and deep industry knowledge to transform operations for the world’s leading corporations in industries including insurance, healthcare, banking and financial services, media and retail, among others. EXL was founded in 1999 with the core values of innovation, collaboration, excellence, integrity and respect. We are headquartered in New York and have more than 54,000 employees spanning six continents. For more information, visit www.exlservice.com.
EXL Chennai, Tamil Nadu, IND Office
Chennai, India
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