Senior Executive - Operations
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About the Role
Review, Call, Analyze and Manage assigned outstanding receivables portfolio by ensuring outstanding/denied claims are resolved, follow up effectively for additional information as needed with insurance companies for claims resolution, follow up with the insurance company on the outstanding/denied claims and resolve them within the timelines and defined Service Level Agreements (SLA’s),
Full Job Posting
Responsibilities
- Interact and probe the insurance representative to get the required status update and have the claim resolved
- Ensure Daily Productivity targets are met at the required quality level on the assigned inventory,
- Perform timely follow up on claims to avoid revenue loss, Prioritize the pending claims for calling from the aging bucket,
- Review claims that have not been paid by insurance companies,
- Check insurance information provided by patient if it is insufficient or unclear,
- Follow the guidelines and applicable rules while calling insurance companies for confidentiality and HIPAA compliance,
- Escalate difficult collection situations to management in a timely manner, Handling patients billing queries and updating their account information,
- Post cash and write off the contractual adjustments accordingly while working on the accounts,
- Meeting daily/weekly and monthly targets set for an individual
- - Interact and probe the insurance representative to get the required status update and have the claim resolved - Ensure Daily Productivity targets are met at the required quality level on the assigned inventory, - Perform timely follow up on claims to avoid revenue loss, Prioritize the pending claims for calling from the aging bucket, - Review claims that have not been paid by insurance companies, - Check insurance information provided by patient if it is insufficient or unclear, - Follow the guidelines and applicable rules while calling insurance companies for confidentiality and HIPAA compliance, - Escalate difficult collection situations to management in a timely manner, Handling patients billing queries and updating their account information, - Post cash and write off the contractual adjustments accordingly while working on the accounts, - Meeting daily/weekly and monthly targets set for an individual
Qualifications
- REQUIRED EDUCATION/EXPERIENCE: Graduate in any stream; customer service; must be computer literate; have multi-tasking skills, excellent organizational skills, verbal and written communication skills; team player.
- YEARS OF EXPERIENCE:
- 2-5 Years for A2 Band
- POSITION RELATIONSHIPS:
- Reports directly to the Assistant Manager
- KNOWLEDGE, SKILLS, AND EXPERIENCE:
- Good organizational skills and the ability to multi-task
- Ability to operate basic office equipment, answer multi-line telephones, and have a strong computer background.
- Establish and maintain effective working relationships with patients, insurance companies, and staff.
- Good written and oral communications.
- Knowledge and skills in working with computerized billing systems including practice management software and EMR.
- Must adhere to all HIPAA guidelines and regulations.
- Knowledge of medical insurance and authorization processes.
- Some medical terminology and experience working in a healthcare or insurance environment.
- LEGAL and COMPLIANCE:
- Maintain patient and company confidentiality.
- Practice within the scope of education, training, and personal capabilities.
- Document company documents (hard copy and electronic) accurately.
- Use appropriate guidelines for releasing information.
- Maintain awareness of US federal and US state health care legislation and regulations, PHI, HIPAA
- WORKING HOURS:
- 40 hours per week as Full-time employee
- Shift time: 7:30 PM IST - 4:30 AM IST
- Weekends Off
- TELECOMMUTER/INTERNET REQUIREMENT:
- High Speed internet connection at home, must be broadband with minimum of 100 MBPS Speed or above
- Must understand and adhere with telecommuter policy
- Must have power backup at to mitigate power outage
- - REQUIRED EDUCATION/EXPERIENCE: Graduate in any stream; customer service; must be computer literate; have multi-tasking skills, excellent organizational skills, verbal and written communication skills; team player. YEARS OF EXPERIENCE: - 2-5 Years for A2 Band POSITION RELATIONSHIPS: - Reports directly to the Assistant Manager KNOWLEDGE, SKILLS, AND EXPERIENCE: - Good organizational skills and the ability to multi-task - Ability to operate basic office equipment, answer multi-line telephones, and have a strong computer background. - Establish and maintain effective working relationships with patients, insurance companies, and staff. - Good written and oral communications. - Knowledge and skills in working with computerized billing systems including practice management software and EMR. - Must adhere to all HIPAA guidelines and regulations. - Knowledge of medical insurance and authorization processes. - Some medical terminology and experience working in a healthcare or insurance environment. LEGAL and COMPLIANCE: - Maintain patient and company confidentiality. - Practice within the scope of education, training, and personal capabilities. - Document company documents (hard copy and electronic) accurately. - Use appropriate guidelines for releasing information. - Maintain awareness of US federal and US state health care legislation and regulations, PHI, HIPAA WORKING HOURS: - 40 hours per week as Full-time employee - Shift time: 7:30 PM IST - 4:30 AM IST - Weekends Off TELECOMMUTER/INTERNET REQUIREMENT: - High Speed internet connection at home, must be broadband with minimum of 100 MBPS Speed or above - Must understand and adhere with telecommuter policy - Must have power backup at to mitigate power outage
About EXL
EXL is a global data and AI company that provides analytics, digital operations, and industry-specific services to enterprises in insurance, healthcare, banking, retail, media, and energy.
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