Subject Matter Expert - AR
Job Title:
Subject Matter Expert - AR
Job Description:
A Subject Matter Expert (SME) is an important part of the team. An SME has proficiency in his or her subject and guides other professionals on the project to ensure the content is accurate. Their role is essentially to ensure the facts and technical details of coding are correct.
This position functions as a resource and subject matter expert on problem solving medical accounts receivable issues that would be considered of medium to high degree of complexity
Experience Range:
4 - 6 years
Educational Qualifications:
Any graduation
Job Responsibilities:
- Assist with training for all new AR staff, serving as the SME for accounts receivable questions from staff.
- Assists with obtaining educational materials for the AR staff
- Reviews medical records to determine if the services identified were medically necessary in accordance with the state policies and federal regulations.
- Performs assigned additional project related responsibilities that are considered small to medium in nature.
- Responsible for calling Insurance companies (in US) on behalf of doctors/physicians and follow up on outstanding Accounts Receivable
- To prioritize the pending claims for calling from the aging basket
- Should be able to convince the claims company (payers) for payment of their outstanding claims.
- To check the appropriateness of the insurance information given by the patient if it is inadequate or unclear.
- To make a physical call by following the international norms and applicable rules for confidentiality and HIPAA compliance
- Review provider claims that have not been paid by insurance companies
- Post cash and write off the contractual adjustments accordingly while working on the accounts.
- Meeting daily/weekly and monthly targets set for an individual.
- In case the patient does not have sufficient insurance coverage for the medical procedure or if the patient is in any way not eligible for coverage, transfer the outstanding balance to the patient.
- Sound knowledge of U.S. Healthcare Domain (Provider side) methods for improvement on the same
- To coach team members. Identifies development areas and helps the individuals and the team to improve their performance and enhance their potential.
- Ability to take supervisory calls
Skills Required:
Good Communication Skills , Neutral Accent , Good Domain Knowledge , Aptitude Skills , Team Player , Analytic Problem Solving , typing skills
Candidate Attributes:
- Ready to work in US shifts.
- Experience in Healthcare Revenue Cycle Management process.
- Strong written and verbal communication skills.
- Neutral Accent ( No MTI)
- Good computer skills including Microsoft Office suite.
- Ability to prioritize and manage work queue.
- Ability to work independently as well as in a team environment.
- Strong analytical and problem-solving skills.
- Ability to perform other responsibilities and assist with special projects.
- Ability to learn quickly and also provide training to others.
- Sharing of knowledge and best practices.
- Adherence to compliance norms.
- Good typing skills with a speed of min 30-35 words /min
Job Code: KL-OPS-SME-CHN-1
About Us
iHealth Innovations, an innovation-enabled revenue performance and advisory company for physician practices and medical groups is a Product driven organisation and helps providers successfully navigate to the future of healthcare.
iHealth is the only innovator focused on integrating revenue cycle management with business intelligence, analytics, care coordination and population health which can help hospitals and physicians increase their existing revenue stream, uncover new payment opportunities and elevate RCM to Revenue Cycle Performance™.
iHealth's new W.R.A.P (Wellness Revenue Assistance Program™) service offers provider education, EHR workflow optimization and a regulatory focused approach to monitoring program performance metrics including MACRA.
iHealth is the only innovator focused on integrating revenue cycle management with business intelligence, analytics, care coordination and population health which can help hospitals and physicians increase their existing revenue stream, uncover new payment opportunities and elevate RCM to Revenue Cycle Performance™.
iHealth's new W.R.A.P (Wellness Revenue Assistance Program™) service offers provider education, EHR workflow optimization and a regulatory focused approach to monitoring program performance metrics including MACRA.
Why Us?
iHealth Innovations is an Employer of Choice (EOC) targeting to recruit more than 500 new employees in 2017. IHealth offers a very competitive compensation and benefits package along with a dynamic and challenging environment.
• You will be part of the growth which would help them to move to the next level in your careers.
• Gives an Opportunity to learn from some of the healthcare veterans that are a part of iHealth.
• An employee friendly management with an open-door policy and benefits at par with the major RCM companies.
• Competitive Environment
• Encourage Learning by allocating good budget for learning
• You will be part of the growth which would help them to move to the next level in your careers.
• Gives an Opportunity to learn from some of the healthcare veterans that are a part of iHealth.
• An employee friendly management with an open-door policy and benefits at par with the major RCM companies.
• Competitive Environment
• Encourage Learning by allocating good budget for learning
