Senior Associate AR

What You Will Do

• Identify inpatient/observation accounts requiring NOA (Notification of Admission)
• Submit notifications via payer portals, EDI, fax, or calls
• Initiate non-clinical authorizations where applicable
• Document reference / authorization numbers in the system
• Track status and perform timely follow-up on pending / rejected submissions
• Ensure compliance with payer timeliness requirements
• Maintain accurate documentation in system notes / billing summary
• To prioritize the pending claims for calling from the aging basket to make a physical call by following the international norms and applicable rules for confidentiality and HIPAA compliance.
• Responsible for working on Denials, Rejections, LOAs to accounts, making required corrections to claims.
• Shall understand and abide by the organizations information security policy and protect the confidentiality, integrity and availability of all information assets.
• Shall report incidents related to security of information to concerned authorities.

Scope Boundaries

• NOA submission
• Payer follow-up
• Documentation

• Clinical review / medical necessity
• Level-of-care decisions
• Appeals physician advisor services

Account Exclusions (as per SOP)

• Medicare FFS
• Self-pay / charity
• Workers Compensation / liability
• Hospice / research
• Other payer-specific exclusions

Key KPIs

• NOA Timeliness Compliance (%)
• First-Pass Submission Accuracy
• Denial Prevention Rate
• Productivity (Accounts/Day)
• Follow-Up Turnaround Time (TAT)

What You Will Need

• Must be a Graduate
• Strong English spoken communication skills and also required reading and writing
• Must have 2 + yrs of experience in US Healthcare stream in AR
• Willingness to work night shifts
• Ability to handle payer communication channels (portals, EDI, fax, calls)
• Detail understanding and documentation of AR follow-up and denial management processes (Preferred NOA skills)

What Would Be Nice To Have

• Experience in MS Office Suite

Disclaimer: This job posting has been aggregated from external source. Role details, content, and availability are subject to change. Applicants are advised to confirm the latest information directly on the company website before applying.