Job Description

The 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.

Job REQUIREMENTs

To be considered for this position, applicants need to meet the following qualification criteria:

• 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

• Freshers with good typing and communication skill may also apply

GROW YOUR CAREER WITH Pacific BPO, an access healthcare company