Skill required: Billing - Payer Eligibility & Enrollment
Designation: Health Admin Services Associate Manager
Qualifications:Any Graduation
Years of Experience:11-14 Years
About Accenture
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What would you do? Accurately prepare and submit medical claims to insurance companies, using electronic billing systems and ensuring compliance with coding standards. Respond to billing inquiries and disputes from patients and insurers through email and written correspondence, providing detailed explanations and resolutions. Work closely with healthcare providers to gather necessary documentation and information, facilitating accurate and timely billing. Regularly review patient accounts and billing processes for accuracy and efficiency, implementing necessary improvements. Stay informed about industry changes, including billing practices, coding updates, and healthcare regulations, to maintain billing accuracy and compliance.
What are we looking for? Bachelor’s degree in finance, Accounting, Healthcare Administration, or a related field. Experience in medical billing, a strong understanding of medical terminology, and proficiency in ICD10 and CPT coding. Excellent written communication skills, capable of handling billing inquiries and documentation with professionalism and clarity. Detailoriented with the ability to identify billing errors and initiate corrective action. Strong organizational skills, with the capacity to manage multiple tasks and prioritize effectively in a fastpaced environment.
Roles and Responsibilities: • Excellent Knowledge of comprehensive RCM processing including claims submission, charge entries/, Aging/AR followup is desirable. • Knowledge of insurance and benefit verification process is desirable • Required to handle a team / group • Thorough understanding of RCM processes like Billing, Cash Posting, Credit Balance, Accounts Receivables, Denial Management & Correspondence review • Very good understanding of RCM metrics like Days in AR, Unposted Cash, UI metric • Periodically review with team’s performance and recommend performance improvement plan wherever required. • Handson experience in preparing daily, weekly & monthly operational metrics reports from the Practice Management/Billing System and workflow tool using MSExcel • Identify trends and patterns from the generated reports and initiate action plan to resolve the posting related issues • Provides regular revenue management reports to management. Provide periodic status reports and ensures timely identification and reporting of potential risks to positive cash flow, public image, or legal compliance. • Ensures medical compliance with state mandate and regulation (maintain commercial billing, medical record regulations and standards (USA) while maximizing reimbursement for patient claims) • Works with payor companies and agencies or other outside parties, including judicial and regulatory bodies, commercial payers, collection agencies, and auditors to address and resolve disputes and unpaid claims, develop procedures, or address other pertinent needs. • Holds responsibility for implementation and standardization of the policies and procedures involved in the management of the billing collection cycle.