Operations Support Associate
We are looking for Operations Associate to join our Operations team. Your Job will be responsible for working on health insurance claims, remittances, clinical documents, clinical mapping and or acknowledgements, including those which have been rejected and those for which the status is unknown. But enough about us; let’s talk about you.
Being an RCM expert, you are a person with good communication and documentation skills and, will be responsible to own T&S function for a particular line of business within Revenue Cycle function and will co-ordinate with both internal (Service Integrity) and external (BPO teams) stakeholders to ensure seamless training and delivery of workflow changes across the LOB. You work and co-ordinate with Procedural Quality team to address any training needs that may come as a result of our established quality process with supporting by answering clarifying questions from BPO team/s.
The Team: The Training and Support team is responsible for working with our service integrity function to confirm workflows, prepare procedure manuals to then deliver to BPO teams to process work appropriately. The responsibility is to provide detailed training to the BPO trainers to then disseminate the update to the agents. All questions, clarifications and escalations from BPO teams will as well be addressed by a member of T&S team to close loop the training feedback process.
Analyze complex breakdowns in the process associated with follow-up, denials management, payment posting related and or clinicals related issues through performing root cause analysis and provide appropriate next steps to BPO teams
Research payer or client and process specific requirements through clarification process and provide insights and recommendation to stakeholder teams
Analyze and resolve root-cause issues by working with vendors, payers and various athena departments that are stakeholders
Analyze reports at a day to day operations level and provide insights to the management team indicating sharp spikes or dips in volume
Bachelor’s degree or equivalent
5-7 years’ experience in fast paced environment
Previous experience in healthcare RCM environment.
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