Job Description

We are a reputable software company specializing in the healthcare industry. Since 1988 we have been servicing the healthcare industry by providing various products to laboratories, hospitals and doctors. As a member of our organization you will be joining a smart and driven team that shares your passion for exploration and discovery in the Healthcare Software vertical. Our significant investment in people, processes, and technology equips our employees with the resources and opportunities to drive substantial value for all our client partners.

Roles & Responsibilities:

Eligibility Verification:

• Verify patient eligibility and benefits through payer portals and insurance calls
• Work on eligibility-related denials and exceptions
• Handle eligibility faxes and paper claims
• Review and resolve eligibility bucket scenarios
• Identify and resolve insurance-related issues impacting claims
• Ensure accurate insurance information to avoid future denials
• Maintain and update process documents/SOPs when required

Payment Posting:

• Perform ERA and EOB payment posting activities
• Work on electronic and paper remittances
• Handle payment posting from AR escalations
• Perform manual posting of EOBs received through email/fax
• Reconcile payer portals to ensure all payments are posted accurately
• Identify and report payment discrepancies and enrollment-related issues

Qualifications

• Good understanding of US Healthcare End-to-End RCM process
• Experience in Physician RCM preferred
• Strong communication skills (written and verbal)
• Good email and telephone etiquette
• Proficiency in MS Office (Word, Excel, PowerPoint, Outlook)
• Ability to work with insurance portals and payer websites
• Knowledge of reporting and process metrics based on experience level

Additional Information

• Transportation Faciity for Females/ Travel allowance for Males
• Health Insurance and Other Benefits