EXL

Senior Executive - Operations

In short

This role is for an AR Caller handling US Healthcare accounts receivable, calling insurance companies to resolve claims, follow up on unpaid claims, and meet daily/weekly/monthly productivity targets. It requires 3 to 5 years of experience in US Healthcare AR Calling, a Science degree, and excellent oral and written communication skills, plus knowledge of HIPAA compliance, MCR LCD/NCD Guidelines, and specialties like Surgery, ASC, Ortho, Neuro, and Pain Management. The job is full-time, 40 hours a week, with a night shift (5:30 PM - 2:30 AM IST) and weekends off, and may involve telecommuting with a broadband internet requirement.

Sr. Executive - AR Caller
Qualifications: Science Graduates.
Experience: 3 to 5 years in US Healthcare AR Calling
Communication Skill: Excellent oral and written communication skills
Working Hours:
•40 hours per week as Full-time employee
•Shift time: 5:30 PM IST - 2:30 AM IST
•Weekends Off
Telecommuter/Internet requirements, if applicable:
•High Speed internet connection at home, must be broadband
•Must understand and adhere with telecommuter policy
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
•Should have knowledge on MCR LCD/NCD Guidelines and should know how to utilize the portal for LCD/NCD Guidelines for any CPT or Modifier
Qualifications: Science Graduation
Experience: Should have 3 to 5 years in US Healthcare AR Calling
•Should have knowledge on Surgery, ASC, Ortho, Neuro, and Pain Management
•Excellent oral and written communication skills

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