RCM AR Analyst

Your Role

• Responsible for working assigned claims and running reports to identify claims that require a follow-up and resolve the denial by taking appropriate action as per Modmed guidelines.
• Ensuring timely follow up to save claims from getting written off due to untimely following up.
• Work on Contractual adjustments and write-off projects.
• Analyze previous notes and actions taken on claims; take the correct action on claims not handled correctly previously and bring that to the knowledge of the Quality Team.
• Identify opportunities to improve follow up process and recommend changes to be added/removed in the Practice Instructions or SOPs with any recent changes at the Payer end.
• Attend trainings to learn new updates, technologies, and techniques; enhancing knowledge of various scenarios and keeping abreast with the new updates is an important requirement for this role.
• Continuously self-audit to ensure quality standards are met.
• Review claim thoroughly and explore all possibilities to get claim resolved prior to assigning claims to any other Modmed or client buckets.
• Perform additional tasks or project work as assigned.

Skills Requirements

• 2+ years of experience as AR Follow-ups (Voice) in Physician RCM is a must
• Sound knowledge of working on Billing scrubbers and CH/Payer Rejections
• Understanding of other related functions in the RCM is required
• Proven experience of good Cash collected/Resolution rate
• Strong knowledge of Commercial Federal payers, basic Coding concepts CARC codes
• Knowledge of working and resolving Auto, WC , IPAs etc. is required
• Expert in listening and resolving problems
• Ability to interact positively with team members, peer groups, and seniors
• Being proficient in delivering a high-quality outcome is a must
• Capable of grasping new concepts quickly; Able to comprehend various training aids and process documentation
• Excellent written and verbal communication skills
• Strong knowledge of HIPAA guidelines
• Abide by the organizations information security policy and protect the confidentiality, integrity, and availability of all information assets
• Willing to work from the office in India night shift (5:30PM to 2:30AM).