Job Description

Business Unit:

Resolv was formed in 2022, bringing together a suite of industry-leading healthcare revenue cycle leaders with over 30 years of industry expertise, including Ultimate Billing, First Pacific Corporation, Innovative Healthcare Systems, and Innovative Medical Management. Our DNA is rooted in revenue cycle solutions. As we continue to expand, we remain dedicated to partnering with RCM companies that offer diverse solutions and address today's most pressing healthcare reimbursement and revenue cycle operations complexities. Together, we improve financial performance and patient experience, helping to build sustainable healthcare businesses.

Job Summary:

The Accounts Receivable Associate is responsible for managing and following up on outstanding claims, ensuring timely collections, and resolving payment discrepancies. This role plays a crucial part in the revenue cycle process by reducing outstanding accounts receivable, improving cash flow, and maintaining accurate financial records.

Work Mode: Work from Office

Shift Timings: 8pm to 5am/9pm to 6am (Night Shift)

Location: Mumbai

What We Are Looking For:

Primary Functions:

Claims Follow-Up & Collections:

• Monitor outstanding insurance claims and patient balances.Conduct timely follow-ups with insurance providers to ensure claim resolution.
• Investigate and resolve denials, underpayments, and delays in claim processing.
• Contact patients for outstanding balances, set up payment plans, and provide billing support

Payment Reconciliation & Posting :

• Work closely with the payment posting team to ensure correct application of payments and adjustments.

• Reconcile daily AR reports and accounts to track collections and pending claims.

• Identify and escalate billing errors or discrepancies for resolution.

Denial Management & Appeals:

• Analyze denial trends and collaborate with the billing team to correct recurring issues.

• Prepare and submit appeals for denied or underpaid claims with appropriate documentation.

• Maintain records of appeal status and follow up with insurance carriers.

Reporting & Compliance :

• Generate and maintain aging reports, AR summaries, and collection reports.

• Ensure compliance with HIPAA, Medicare, Medicaid, and private payer policies.

• Document all collection activities and maintain accurate AR records.

Cross-Functional Collaboration :

• Work with the billing, payment posting, and coding teams to resolve claim discrepancies.

• Communicate with insurance representatives and internal stakeholders to streamline the AR

(Mandatory Qualifications & Skills):

• Bachelor’s degree in Accounting, Finance, Business Administration, or a related field (preferred).

• 1+ years of experience in accounts receivable, medical billing, or revenue cycle management.

• Experience with RCM software (e.g., EPIC, Athenahealth, Cerner, eClinicalWorks, NextGen, Kareo, or Meditech).

What Would Make You Stand Out:

(Preferred/Good-to-Have Skills)

• Strong knowledge of insurance reimbursement processes, AR management, and medical billing.
• Familiarity with CPT, ICD-10, and HCPCS codes for claim verification.
• Proficiency in Microsoft Excel, financial reconciliation, and reporting tools.
• Ability to work independently and manage high-volume AR portfolios.

Skills/ Behavioural Skills:

• Problem-Solver: Identifies and resolves healthcare billing discrepancies.
• Organized: Manages high volumes of medical remittances efficiently.
• Clear Communicator: Effectively discusses payment issues with healthcare teams.
• Analytical: Understands healthcare financial data and denial patterns.

Benefits:

• Annual Public Holidays as applicable
• 30 days total leave per calendar year
• Mediclaim policy
• Lifestyle Rewards Program
• Group Term Life Insurance
• Gratuity
• ...and more!