Senior Claim Analyst @ CareerNet

Job Description

Roles and ResponsibilitiesHI ALL,Required SeniorClaimsAnalystfor a TOP Healthcare company
Note: Minimum 1 year experince in RevenueCycleManagementfield
Location:Bangalore
Salary: 4.5LPA to 6LPA
Qualification: Any Graduate with minimum 1 year of experince in RCM.
Age Limit: 34yrs
JobSummarySeniorClaimsAnalyst (SCA)are responsible for the resolutionoferrors,rejectionsanddelinquentclaims.TheSCAresolvestheclaimsbyanalyzing,auditing,andinvestigatingtheirassignedclientsAccountsReceivable(A/R)processinordertoensurequality,resolveerrors,andprovidestrategicsolutions.Generallysupportsasinglepracticemanagementplatformandspecialty.
Responsibilities:-

• Completerejectionreports,sendtoclient;communicatesstatusoftheclientsAccountsReceivable(A/R)andresolveerrors orrejectionsduetocodingerrors,updates,orchargeentryerrorsoromissions
• Completeallaspectsofclaimsprocessingforassignedclientsinatimely,accurate,andhighqualitymanner.Tasksinclude,butnotlimitedto,claimspreparation,submission,reconciliation,correctingclaimerrorsandrejections.Thesetasksapplyto allclaimswhetherprimary,secondaryortertiaryclaims
• PossessasolidunderstandingofassignedclientsprocessinordertostrategicallyreviewandanalyzetheirA/Rfunctions
• Conductregularauditsofspecialistsclaimworkforaccuracyandquality;managescleanclaimratiosforassignedclients
• ProvidedirectiontoClientLeadsonclaimauditcorrectionsandresolution
• Prepareandanalyzereportsofauditreviewsandperformanceissueswithafocusonidentifyingtrends,institutingcontinuousqualityimprovementinitiatives,andidentifyingandprovidingongoingtrainingopportunitiesforspecialists
• Providesecondtierreviewonadvancedandescalatedclaimissuestoasatisfactoryresolution
• Keepcurrentonpaymenttrendsandcodingchangesandensureallapplicablechangesaredisseminatedouttotheteam assignedtoworktheaccount
• Resolveoutsourcevendorsescalatedclaimsandclaimrework
• Logallclientissuesencounteredininternaltrackingsystem,includingenhancementrequests,bugs,errors,andinquiries
• Analyzeunderperformingcustomerstoidentifytrendsandopportunitiesforimprovement
• Submitpossiblemodificationstoprocessandprocedurestopreventclaimreworkthroughautomationideas
• AssistinachievingKeyPerformanceIndicatorgoalsforyourassignedcustomer
• Assistwithonboarding,development,trainingandmentoringofnewhiresandlessexperiencedassociates
• CompleteStrategicAccountProgramformsforquarterlyreviewofTier3customers
• AssistClientLeadswith,andparticipatein,endofmonthcallswithcustomersandbusinesspartners

Interested candidates - ai************k@ca******t.co.in

8217054***

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