Process Associate

Job highlights

• PF, ESI (ESIC), 5 working daysJob DescriptionKey Responsibilities :-Follow up with US insurance companies regarding outstanding and unpaid claims.Contact insurance payers through phone and online portals to check claim status.Analyze EOBs, ERAs, claim status, denials, rejections, and underpayments.Identify the reason for claim denials and take appropriate action for resolution.Work on AR aging and prioritize claims based on aging and outstanding balances.Submit corrected claims, reconsiderations, appeals, and required documentation when applicable.Verify patient eligibility and insurance benefits when required.Document all payer conversations and claim updates accurately in the billing system.Maintain detailed follow-up notes, including reference numbers, call dates, payer responses, and next follow-up dates.Coordinate with the billing, coding, and payment posting teams to resolve claim issues.Escalate complex claims and payer-related issues to the appropriate team.Meet daily productiv

Key Responsibilities :- Follow up with US insurance companies regarding outstanding and unpaid claims. Contact insurance payers through phone and online portals to check claim status. Analyze EOBs, ERAs, claim status, denials, rejections, and underpayments . Identify the reason for claim denials and take appropriate action for resolution. Work on AR aging and prioritize claims based on aging and outstanding balances. Submit corrected claims, reconsiderations, appeals, and required documentation when applicable. Verify patient eligibility and insurance benefits when required. Document all payer conversations and claim updates accurately in the billing system. Maintain detailed follow-up notes, including reference numbers, call dates, payer responses, and next follow-up dates. Coordinate with the billing, coding, and payment posting teams to resolve claim issues. Escalate complex claims and payer-related issues to the appropriate team. Meet daily productivity, quality, and collection targets. Ensure compliance with HIPAA and company policies while handling patient information. Required SkillsGood understanding of the US Healthcare Revenue Cycle Management (RCM) process. Knowledge of AR Follow-Up, Denial Management, and Claims Processing . Familiarity with Medicare, Medicaid, Commercial, and Managed Care payers. Knowledge of common US insurance portals such as Availity and payer-specific portals is preferred. Good knowledge of EOB, ERA, CPT, ICD-10, claim forms, denial codes, and payer remark codes . Excellent verbal and written communication skills. Good analytical and problem-solving abilities. Ability to handle payer calls professionally and confidently. Good typing and computer skills. Ability to work independently as well as in a team.