Underpayment Executive || Pacific || US
- Pacific Bpo
- 1 - 4 years
- Noida, Gurugram
- 5 years ago
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Job Description
JOB DESCRIPTIONThe Executive for Underpayment reviews and resolves patient accounts as per the customer guidelines. The position requires expertise in understanding provider-payer contracts in order to optimize reimbursement by initiating appropriate action. KEY RESPONSIBILITIES:
- Identification of underpayments on patient accounts and taking appropriate action to resolve the account
- Proactively trend and monitor information to ensure that payments are posted as per contracts
- Maintain appropriate data and trends to report back collections, along with any negative collections
- Participate in weekly meetings with the customer to ensure claim denials trends are discussed
- Comply with all reimbursement and billing procedures for regulatory, third party, and insurance compliance norms
- Provide daily reports as assigned including but not limited to: Claim error report, Audit report, Payment Variance
- Work closely with Accounts Receivables Team to resolve account or payer issues, including identifying if underpayment or overpayment issue is related to payor, incorrect insurance, or billing error.
- Work with the contracts team to update contract loading issues so that the correct expected reimbursement is reflected upon pricing of the claim
- Identifies payer problems that relate to billing or collections.
- Participates in Performance Improvement activities.
- 2-4 years of experience in accounts receivables management
- Good understanding of collections processes and managed care contracts
- Ability to read and understand complex contract terms and the ability to communicate and/or resolve the deficiencies with both internal and external customers.
- Strong Mathematical and Analytical Skills
- Graduate Degree in any steam
- Excellent communication skills, both written and verbal.
- Must be flexible to work in shifts
Perks and Benefits
Best In industryJob Classification
Industry: Medical, Healthcare, HospitalsFunctional Area: ITES, BPO, KPO, LPO, Customer Service, Operations, Role Category: VoiceRole: VoiceEmployement Type: Full timeEducation
Under Graduation: Graduation Not Required, Any Graduate in Any SpecializationPost Graduation: Any Postgraduate in Any Specialization, Post Graduation Not RequiredDoctorate: Any Doctorate in Any Specialization, Doctorate Not RequiredContact Details:
Company: Pacific BpoAddress: B-11, SEC 63, NOIDA, Gautam Buddha Nagar, Uttar Pradesh, NOIDA, Uttar Pradesh - 201301,IndiaLocation(s): Noida, GurugramWebsite: https://www.pacificbpo.com/
Keyskills: Daily Reports Accounting Billing Payments Audit Report Accounts Receivable US Healthcare Collections underpayments Auditing Receivable Management
Pacific Bpo
Pacific BPO, an Access Healthcare company, is a leading provider of cost and process optimization solutions to clients in the healthcare industry. We bring technology enabled, and analytics-driven transformation of revenue cycle processes of physician practices, hospitals, and revenue cycle intermed...
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