Job Description

ROLE & RESPONSIBILITIES

As an AR Associate your role will be to:

4 Resolve outstanding facility/physician AR through reviewing the denial posted on the service billed, follow up transactions done post the denial being posted, identify the root cause for the denial and then take corrective actions to resolve the claim. Key responsibilities include:

4 Address and resolve AR inventory assigned while adhering to client specifics, payer specifics and compliant with State and Federal rules and the organization’s Acceptable Usage policy

                        4 Utilize web-based payer resources or phone calls to the payer to identify the root cause for non-payment/delayed adjudication and take corrective action. Corrective action will include: o Claim resubmission for claims not on file or post identifying the appropriate to be billed

                        o Corrected claim resubmission post verification of benefits/charge corrections.

                        o Resolve rejection edits and resubmit the claim

                        o Submission of additional documentation to enable adjudication of the claim as requested by the payer

                        o Submit appeals contesting the reason provided for denying the service rendered with justification for the appeal, with supporting documentation being submitted

                        o Determine the next responsible payer post adjudication of the claim and transfer balance after determining that the payer has adjudicated as per client contract and contractual allowance taken

                        o Recommend timely filing or Appeal limit exceeded claims for write-off/adjustment

4 Concise documentation of review done, action taken on the claim, along with appropriate tracking stamps like claim #, call reference # along with worked date and initials

4 Identify and escalate trends that is impacting resolution of claims submitted to a payer and suggest solutions to submit a clean claim

4Follow up on claims resubmitted/appeals submitted post providing adequate time for payer adjudication/reconsideration

Qualifications

ACADEMIC AND PROFESSIONAL BACKGROUND

                4 University graduate with an average aptitude score

                412 months – 4 years of Physician/Facility AR follow-up experience

                4CRCE/CRCP/CRCS certification will be an added advantage

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Job Description

Responsibilities:

1. Screening resumes

2. Taking telephonic interviews

3. Client coordination

Qualifications

1. Any Graduate

2. 1st or 2nd and final year student of graduation

3. Required excellent Comm. Skills

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