i3 synergist

Mohali, Punjab

This is a work from office position only.Ar Associate-Ideal candidate must have following:Maximize insurance reimbursement for providers Must have work experience of Physician Billing process.Discover root causes for medical insurance claim denial, underpayment, or delay and propose resolutions.Interact with the US-based insurance carriers to follow-up on submitted claims, monitor unpaid claims, delayed processing, and underpayment plan, and execute medical insurance claim denial appeal process.Must have work experience in Personal Injury and Workers Comp AR. Comfortable talking to attorney and adjustors.Must be proficient in denial management and appeal process.Must have excellent documentation skills for maintaining SOPs/guidelines/notes.Review EOB/ERA denials and Patient history notes to understand and resolve denial on a claim.Interact with US-based practice owners and clinicians on completing and correcting any missing or incorrect data on their insurance claims. Must be comfortable in AR calling and have relevant experience.Identify claims that need balance transfer to patient and secondary balances or appropriate financial class for further resolution.Should be able to track and follow up on claims within given TAT.Must be comfortable with other voice process as per business requirement such as patient calling.Required Candidate profile:Completed graduation. Other formal education or training on a practice management system using patient accounting will be added advantage.Relevant experience in a USA health care medical billing or RCM office capacity with related job duties and responsibilities.Must have at least 1+ yrs. experience in physician billing; specifically, chiropractic, mental health, behavioral health etc.Understand CMS-1500 and UB-04 claim formats.Basic knowledge of collection laws, rules, and regulations.Knowledge of medical billing software, preferably Tebra, Therapy Notes, Simple Practice, Theranest, ECW, Epic or any other similar.

Key job Accountability:Responsible for attending patient calls and answering patient queries.Communicate respectfully and politely with all patients.Developing and maintaining a detailed call database.Professionally handle all inbound calls and resolve queries as per TAT guidelines.Responsible for making outbound calls as required.Perform script (with necessary adjustments as required) to ensure consistency of customer/patient queries.Responsible for daily/weekly/monthly MIS reporting via email/CRM/Excel.Experience on Data Entry, Patients Collections, Charges, Denials, Rejections, Eligibility verification, Insurance Processing, Payment Posting, Customer Service duties will be big plus.Answering patient calls as required and providing faster resolutions.Should be comfortable with voice process.Required candidate profile:Relevant experience in a USA health care medical billing or RCM office capacity with related job duties and responsibilities.Experience of QA/Audits and Team management, client interaction/client account management will be big plus.Must have at least 3+ yrs. experience in patient calls. Physician billing; specifically, chiropractic, mental health, behavioral health, nephrology etc.Understand CMS-1500 and UB-04 claim formats. Typing speed, at least 45 WPM.Third party payer requirements. Account management experience will be a big plus.Must have knowledge of medical billing software, preferably Kareo, Therapy Notes, Simple Practice, YouthCare, Theranest or any other similar.Good knowledge of Microsoft 365 office applications like Teams, Outlook, CRM Dynamics, OneDrive etc. Experience of other areas of RCM like credentialing and medical coding will be given preference.

Ideal candidate must have following: Code (CPT and ICD10) all E/M and office procedures. Deep knowledge of auditing concepts and principles. Responsibility of auditing of coding team and maintaining target accuracy %. Adhere to and enforce departmental policies and procedures (coding and compliance). Reviewing office dictation and/or charge ticket (assigned levels by Provider) received from the clinic. Research all coding problems and resolve them with an effective and appropriate solution. Keep up to date on all coding changes by reviewing subscription newsletters (CEUs). Participate in monthly calibration sessions with operations & clients. Providing on the spot feedback. Prepare and review data and QA reporting with key stakeholders. Discuss audit sheets changes on need basis with the operations & clients. Conduct RCA /1 Year analysis on monthly audit data & publish the findings. Conduct monthly quality session for operations teams to share top improvements & preventive actions. Conduct TNA on need basis for junior team members. Facilitate the preparation and processing of daily charge documents. Required Candidate profile: Any life science graduate or postgraduate. B.Sc. Biology preferred. Must have worked on multi specialities including Radiology, ENM, behavioral, nephrology, podiatry, dermatology etc. Must be CPC certified from AAPC or AHIMA, (CPC, COC, CIC, CCS). Experience of medical billing, client management, AR follow up, charge entry, denial management etc. will be added advantage. Should have good knowledge of ICD-9, ICD-10 and/or CPT medical billing codes. Must have medical record auditing experience. Team management experience will be big plus. Proficient in Microsoft 365 office applications like Teams, Outlook, CRM Dynamics, OneDrive etc.