Apprentice - RCM (Non-Tech Fresher)

Role Summary

This job takes the privilege in touching human life as we deal with day-to-day patient encounter with the hospital. Helping Physician to do their work better we ease them with the operational support of handling the claims to the insurance and its entire life cycle until final payment. We connect with US insurance companies to clear the outstanding balance on the claims which requires payment from the insurance companies.

Job Summary

This job gives an opportunity to work in a challenging environment to deliver high quality Solutions to meet the demands for our Global Customer. An ideal candidate should have experience in Hospital Billing and Denial Management. The candidate should be able to lead own the Development of any Technical deliverables assigned to him/her thereby delivering high quality Innovative solutions for the client. Should be an excellent Team player have excellent Problem solving communication skills

Roles and Responsibilities

• Perform pre-call analysis and check status by calling the payer or using IVR or web portal services
• Call Insurance companies on behalf of physicians and carryout further examination on outstanding Accounts Receivables
• Perform Analysis of accounts receivable date and understand the reasons for underpayment/ denial
• Ability to multi-task
• Should follow instructions precisely
• Prioritize unpaid claims according to the length of time it has been outstanding
• Check the relevance of insurance info offered by the patient
• Evaluate unpaid Transactions
• Transfer the outstanding balance to the patient of he/she doesnt have adequate insurance coverage
• If the claim has already been paid, ask the insurance company for Explanation of Benefits (EOB)
• Should take ownership in the process and be responsible for the revenue collection.

Education Required

• Should be a Graduate in any Stream

Experience Required

• Willingness to work in shifts
• Knowledge on Denials management and A/R fundamentals will be an advantage
• Good written verbal communication skills
• Good analytical skill in identifying trends and bulk issues
• Strong knowledge of US AR, revenue cycle management for Physician Practices will be an advantage