[Hiring] Executive - Underpayments Review @Pacific BPO

Role Description

If you want to do more with your healthcare career and deepen your knowledge of healthcare revenue cycle management, you have to look at your healthcare business processes from the customer’s lens. Get smarter about the business of healthcare, join a company that values your work and enables you to become a true partner to your clients by investing in your growth besides empowering you to work directly on KPIs that matter to your clients.

If you possess good knowledge of accounts receivable processes and managed care contracts, we offer you an opportunity to fast track your career as an executive - underpayments. We are always interested in talking to inspired, talented, and motivated people. Many opportunities are available to join our vibrant culture.

The Executive for Underpayment reviews and resolves patient accounts as per the customer guidelines. The position requires expertise in understanding provider-payer contracts in order to optimize reimbursement by initiating appropriate action.

KEY RESPONSIBILITIES:

• Identification of underpayments on patient accounts and taking appropriate action to resolve the account.
• Proactively trend and monitor information to ensure that payments are posted as per contracts.
• Maintain appropriate data and trends to report back collections, along with any negative collections.
• Participate in weekly meetings with the customer to ensure claim denials trends are discussed.
• Comply with all reimbursement and billing procedures for regulatory, third party, and insurance compliance norms.
• Provide daily reports as assigned including but not limited to: Claim error report, Audit report, Payment Variance.
• Work closely with Accounts Receivables Team to resolve account or payer issues, including identifying if underpayment or overpayment issue is related to payor, incorrect insurance, or billing error.
• Work with the contracts team to update contract loading issues so that the correct expected reimbursement is reflected upon pricing of the claim.
• Identifies payer problems that relate to billing or collections.
• Participates in Performance Improvement activities.

Qualifications

• 2-4 years of experience in accounts receivables management.
• Good understanding of collections processes and managed care contracts.
• Ability to read and understand complex contract terms and the ability to communicate and/or resolve the deficiencies with both internal and external customers.
• Strong Mathematical and Analytical Skills.
• Graduate Degree in any stream.
• Excellent communication skills, both written and verbal.
• Must be flexible to work in shifts.
• Freshers with good typing and communication skills may also apply.