Id - REV00306
Title - Senior Revenue Analyst (End-to-End)
BU - Revenue Cycle Management
Location - Bangalore
Office Location - Consero Bangalore
Employment Type - Full-time
Good To Have Skills - Revenue Cycle Management, Denial Management Concept
Must Have Skills - medical services, coding compliance guidelines, OTP- Opiod Treatment Program Billing, AR Caller, IVR /Web Portal, billing
Experience Level - 3 - 5 Years
Employee Type - Salaried
External Description -
Medical Billing - Revenue Senior Analyst (End to End)
Need to have exposure to OTP- Opiod Treatment Program Billing
Job Description:
- Accurately review and post charges for medical services provided by healthcare providers
- Analyze patient encounter documentation, such as super bills, operative reports, and medical records, to ensure accurate charge capture and appropriate code assignment
- Adhere to billing and coding compliance guidelines, including HIPAA regulations, insurance payer guidelines, and government regulations (e.g., Medicare, Medicaid)
- Collaborate with the denial management team to promptly resolve charge-related denials and rejections
- Post all insurance and liability payments from Remittance and EOB's to appropriate accounts with no errors
- Apply manual payments and auto payments to accounts for payor types of Medicare, Medicaid and Commercial Insurances
- Analyze EOB information, including co-pays, deductible, co-insurance, contractual adjustments, denials and more to very accuracy of patient balances
- Add appropriate ANSI denial codes and comments to assure all necessary appeals and post payment follow up can take place
- Investigate the source of unidentified payment to ensure they are applied to appropriate accounts. If necessary, will contact the sender to clarify where the payment should be posted
- Reconcile shortage on both paper and electronic EOBs to determine proper allowance and correct write off
- Assist in updating the Direct Deposit Daily, assist in performing comparison of downloaded files to the Direct Deposit and correct any discrepancies, assist in setting up Electronic Remittance Advices (ERA) for Commercial and Medicare payors and assist in running and balancing credit cards daily
- Send all batch reconciliation information and assist in performing check deposits and assembling logs daily.
- Contact insurance or third party administrators when clarification of information is needed to successfully post payment
- Work on recoupment accounts to settle, follow up with outstanding A/R all payers and/or including self-pay and/or including resolution of denials
- Read, analyze, and interpret common scientific or technical information, financial reports and legal documents
- Research inquiries in a professional and courteous manner and work with Accounts Receivable team members, to identify and resolve escalated customer concerns in a timely manner, potentially without direct Supervisor oversight.
- Review the claim allocated and check status by calling the payer or through IVR /Web Portal.
- Ask a series of relevant questions depending on the issue with the claim and record the responses.
- Prepare call notes, initiate or execute the corrective measures by sending necessary documents to Payers.
- Record the actions and post the notes on the clients revenue cycle platform.
- Use appropriate client specific call note standards for documentation.
- Adhere to Company's information, HIPAA and Security Guidelines.
External Skills And Expertise -
Job Requirements:
- The candidate must have experience in OTP- Opiod Treatment Program Billing
- Should have worked as an AR Caller for at least 2 to 4 years with Medical Billing service Providers.
- Good knowledge of Revenue Cycle Management and Denial Management Concept.
- Positive attitude to solve problems.
- Ability to absorb clients business rules.
- Strong communication skills with a neutral accent.
- Graduate degree in any field.
