Operations Executive

Executive - AR:-

 • Average ability on calling, spoken and written English with moderate medical billing knowledge. 

• Should be able to work independently with minimal supervision, on moderate and complex tasks with guidance from supervisors 

• Should be a team player and collaborate in solving the issues and problems. 

Roles & Responsibilities: 

• Ability to talk to insurance companies & check online for outstanding payments and document the conversation/ findings on patient account and assigned WP as per the standardization protocol with required accuracy. 

• Willingness to work in the night shift 

• Meet Compliance requirements like HIPPA etc. 

• Meet QMS and ISMS requirements 

• Meet productivity and quality standards.

Sr. Executive - AR:-

• Above average calling, spoken and written English skills, high medical billing knowledge 

• Should work independently, and with minimal supervision, on complex tasks with guidance from supervisors 

• Should be a team player and collaborate in solving the issues 

Roles & Responsibilities: 

• Ability to analyze a claim and talk to insurance companies & check online for outstanding payments and take necessary action, so that the claim is closed 

• Mentor and guide team members 

• Willing to work in Night shifts 

• Ensure required quality standards.

Analyst - AR:-

• Offers solutions, suggestions & improvements and also help on client specific reports to their immediate supervisor 

• Should be a team player, mentor the trainees and collaborate in solving the issues and problems 

Roles & Responsibilities: 

• Should have the ability to identify global issues, root cause of the problem and take corrective and systemic actions. 

• Ensure required quality standards. 

• Clear the rejections 

• Check whether the response is received in a timely manner 

• Check process dashboard on time; if any rejection found 

• Generate Insurance Collection summary report grouping by Insurance and sub-grouping. 

• Work on the denial bucket claims 

• Resolve the denied claims 

Sr. Analyst - AR:-

• Capable of handling minimum team of 5-10 

• Identify the global issues proactively and offer resolutions and recommendation to eradicate from reoccurring. 

• Should be able to mentor the team members 

• Ability to generate client specific reports and assist immediate supervisor on day to day operational needs. 

• Exceed individual productivity and quality standards as per org policy. 

• Assist team to achieve the minimum productivity and quality benchmark. 

• Should be a team player and collaborate in solving the issues and problems. 

Roles & Responsibilities: 

• Should have the ability to identify global issues, root cause of the problem and take corrective and systemic actions. 

• Ensure required quality standards. 

• Clear the rejections 

• Check whether the response is received in a timely manner 

• Check process dashboard on time; if any rejection found 

• Generate Insurance Collection summary report grouping by Insurance and sub-grouping. 

• Work on the denial bucket claims 

• Review EOB, post the denials and take appropriate action on the denials. 

• Resolve the denied claims.

WHO YOU ARE

To be successful in this role, you’ll need to have the following skills:

·         Love for coding: A fanatic about writing beautiful and scalable code.

·         A sense of analytics: Strong analytical and troubleshooting skills. Should be resourceful, innovative and inventive.

·         Dynamic: Should be comfortable in dealing with lots of moving pieces. Have exquisite attention to detail, and are comfortable learning new technologies and systems. 

·         Team player: Knack for influencing without being authoritative. Pitch in wherever the team needs help, from writing blog posts to supporting customers.

·         Accountability: High sense of ownership for your code and relentlessness to deliver projects with high business impact. 

KEY QUALIFICATIONS

·         BE/BTech in Computer Science or related field. 

·         5+ years of professional production and development experience with leading-edge server and database technologies (e.g., Python, Java, Node.js, Scala, Spring Boot, MySQL, and NoSQL databases).

KEY SKILLS

·         Strong computer system analysis and design skills in current methodologies and patterns Experience with professional production cloud (AWS preferred).

·         Experience with RESTful Services and APIs.

0 - 2  years of experience in business analysis and product development of mobile or web applications 
• Working with the stakeholders to formulate and define the Product Vision and Roadmap
• Developing requirements and use cases for business process flows
• Facilitating the definition of project scope, goals, and deliverables
• Managing the Product Backlog and its refinement
• Converting the requirements to Epics and user stories along with specifying the acceptance criteria
• Managing the prioritization of work in Product Backlog based on Product Roadmap
• Coordinating with cross-functional development team to impart requirement understanding including collaboration with the QA team on test cases
• Engaging with the stakeholders on project progress, required reports and value delivery