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Eligibility Verification @ Thryve Digital

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 Eligibility Verification

Job Description

Job Title: Senior AR Collections Agent

Department: Revenue Cycle Management

Reports To: AR Collections Supervisor/Manager

Location: Chennai/Hyderabad

Summary:

The Senior AR Collections Agent is responsible for the timely and effective collection of outstanding accounts receivable (AR) for healthcare services. This role involves in-depth knowledge of medical billing, coding, payer regulations, and collection techniques. The Senior Agent handles complex cases, provides guidance to junior team members, and plays a key role in improving the overall collection process.

Key Responsibilities:

Collections Activities:

  • Manage and resolve complex and high-dollar AR claims.
  • Investigate and analyze aged AR to determine appropriate collection strategies.
  • Contact insurance companies, patients, and other responsible parties to pursue payment.
  • Document all collection activities accurately and thoroughly in the billing system.
  • Review and interpret Explanation of Benefits (EOBs) to identify discrepancies and denials.
  • Appeal denied claims and follow up on pending appeals.
  • Negotiate payment plans with patients according to established guidelines.
  • Identify and escalate problematic accounts to management for further action.
  • Understanding of HIPAA regulations and ensure compliance in all activities.
  • Stay current on changes in payer regulations, coding guidelines, and billing requirements.

Problem Solving and Analysis:

  • Identify trends in denials and payment issues and propose solutions to prevent recurrence.
  • Work with other departments (e.g., billing, coding, registration) to resolve billing errors and process issues.
  • Research and resolve complex billing inquiries from patients and insurance companies.

Mentorship and Training:

  • Serve as a mentor and resource for junior AR Collections Agents.
  • Assist in training new team members on collection procedures and systems.
  • Provide guidance on handling difficult or complex accounts.

Reporting and Process Improvement:

  • Prepare regular reports on AR status, collection rates, and key performance indicators (KPIs).
  • Identify opportunities to improve collection processes and increase efficiency.
  • Participate in team meetings and contribute to process improvement initiatives.

System Proficiency:

  • Utilize billing software and other relevant systems to manage accounts and track collection activities (e.g., EPIC, Cerner, etc.).
  • Maintain accurate and up-to-date information in the billing system.

Qualifications, Experience & Skills:

  • Undergraduate degree or equivalent required; Associate's or Bachelor's degree in a related field preferred.
  • Minimum of 5-7 years of experience in Phycian Billing/Hospital billing RCM AR collections.
  • Proven track record of successfully collecting outstanding AR.
  • Experience working with various insurance payers (e.g., Medicare, Medicaid, Commercial).
  • In-depth knowledge of revenue cycle management
  • Strong understanding of payer regulations and reimbursement processes.
  • Excellent communication and interpersonal skills.
  • Strong analytical and problem-solving abilities.
  • Proficiency in using billing software and Microsoft Office Suite.
  • Ability to work independently and as part of a team.
  • Excellent organizational and time-management skills.
  • Ability to handle a high volume of accounts and meet deadlines.

Preferred Qualifications:

  • Experience with EPIC preferred but not mandatory
  • Both Hospital and Professional billing experience preferred
  • Flexible to work from Office all 5 days in the week in US shift

Job Classification

Industry: IT Services & Consulting
Functional Area / Department: Healthcare & Life Sciences
Role Category: Health Informatics
Role: Health Informatics - Other
Employement Type: Full time

Contact Details:

Company: Thryve Digital
Location(s): Hyderabad

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Keyskills:   ar claims Eligibility Verification

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Thryve Digital

https://www.thryvedigital.com/