Accounts Receivable Analyst

📋 Description

• • TruBridge is seeking a dedicated and analytical Accounts Receivable Analyst to join our remote team in India. In this crucial role, you will be instrumental in ensuring timely and accurate payment for services rendered by healthcare providers. You will be the primary point of contact for insurance companies, meticulously following up on claims, analyzing payment discrepancies, and converting denials into successful payments. This position requires a proactive approach, strong problem-solving skills, and a deep understanding of the US healthcare revenue cycle.
• • Your day-to-day responsibilities will involve performing comprehensive pre-call analysis to understand the status of outstanding claims. This includes actively contacting payers via phone, utilizing Interactive Voice Response (IVR) systems, or navigating payer web portals to gather essential information. Maintaining meticulous documentation within our client software is paramount; you will ensure all necessary documentation is sent to insurance companies and that a clear audit trail is established for future reference and compliance.
• • Following each interaction, you will meticulously record after-call actions and conduct post-call analysis to effectively manage claim follow-up. A key aspect of your role is to provide accurate information to insurance companies. This involves thorough research of available documentation, such as authorizations, physician notes, and medical documentation stored within the Practice Management (PM) system. You will also interpret Explanation of Benefits (EOBs) received to understand payment details and identify any discrepancies before initiating contact.
• • A significant part of your contribution will be the analysis of accounts receivable data. You will delve into the reasons behind underpayments, analyze the days in Accounts Receivable (A/R), and identify the top denial reasons. Utilizing appropriate coding, you will accurately document the root causes of denials and underpayments, providing valuable insights for process improvement.
• • You will be responsible for ensuring strict compliance with all reimbursement and billing procedures, adhering to regulatory, third-party, and insurance compliance norms. Meeting daily, weekly, and monthly productivity and quality work expectations is essential for success in this role. This includes achieving specific targets for claim processing, denial conversion, and audit accuracy.
• • The role encompasses end-to-end claim processing and submission. You will submit claims to insurance companies, initiating the revenue cycle for services provided by healthcare providers. A critical function is obtaining denial status updates from various insurance carriers and proactively working to resolve these denials. This involves checking claim status based on their suspension and denial reasons, and meticulously following up on fresh claims, existing denials, and appeals.
• • Eligibility and policy verification are also key responsibilities. You will ensure that patient insurance policies are active and that coverage is verified before or during the claim submission process. This proactive step helps minimize rejections and delays.
• • Converting denials into payments is a core objective. You will employ your analytical skills and knowledge of healthcare billing to appeal denied claims and secure payment. This requires a deep understanding of payer policies and effective communication strategies.
• • Adherence to the Health Insurance Portability and Accountability Act (HIPAA) is non-negotiable. You will maintain the highest standards of patient data privacy and security in all your activities.
• • Ultimately, your success will be measured by your ability to achieve weekly and monthly production and audit targets, contributing directly to the financial health of the clients we serve. This role offers a challenging yet rewarding opportunity to make a tangible impact within the US healthcare revenue cycle management sector.