Client Partner - Accounts Receivable

This role is for a dedicated Client Partner - Accounts Receivable, focusing on the crucial task of managing and resolving outstanding claims for US healthcare customers. The ideal candidate will possess strong analytical and communication skills, with a focus on maximizing revenue recovery and maintaining meticulous documentation.

Responsibilities

• Perform pre-call analysis and check claim status by calling the payer or utilizing IVR/web portal services.
• Maintain adequate documentation on client software, ensuring a clear audit trail and facilitating the submission of necessary documents to insurance companies.
• Record after-call actions and perform post-call analysis for effective claim follow-up.
• Assess and resolve inquiries, requests, and complaints through calling, striving for first-point resolution of customer inquiries.
• Provide accurate product/service information, research available documentation (including authorization, nursing notes, medical documentation on client systems), and interpret Explanation of Benefits (EOBs) before making calls.
• Conduct thorough analysis of accounts receivable (A/R) data to understand reasons for underpayment, days in A/R, and top denial reasons.
• Use appropriate codes for documentation of denial/underpayment reasons.

Skills

• Fluent verbal communication abilities and call center expertise.
• Strong analytical and problem-solving skills for A/R data analysis.
• Knowledge of denials management and A/R fundamentals will be preferred.
• Basic working knowledge of computers.
• Ability to interpret Explanation of Benefits (EOBs) and medical documentation.
• Knowledge of Healthcare terminology and ICD/CPT codes will be considered a plus.

Qualifications

• Relevant experience in accounts receivable follow-up/denial management for US healthcare customers.
• Prior experience working in a medical billing company and using medical billing software will be considered an advantage.
• Willingness to work continuously in night shifts.