Job Title: Process Executive – Accounts Receivable (AR)
Department: Accounts Receivable / Healthcare Operations
Reporting To: AR Supervisor / AR Manager
Role Description Overview:
The Process Executive – Accounts Receivable (AR) is responsible for managing day-to-day AR activities, including claims follow-up, denials management, and ensuring accurate and timely processing of claims and payments. The role focuses on ensuring that all claims are addressed efficiently, productivity and collection targets are met, and client satisfaction is maintained. The Process Executive will be required to communicate with insurance carriers, update logs, and escalate issues when necessary.
Key Responsibilities:
Claims Follow-Up & Denials Management:
Review and process denied claims, ensuring that all necessary documentation and actions are taken for resolution.
Follow up on pending claims with insurance carriers, ensuring timely processing and payment.
Maintain accurate records of communication and action taken for each claim in the system.
Identify trends in denials and escalate recurring issues to the appropriate team members.
Data Entry & Documentation:
Accurately enter and update claims data in the system to ensure that all claims are tracked and processed.
Maintain up-to-date records in spreadsheets and AR software tools.
Ensure that all claims statuses, including pending, denied, or paid claims, are updated promptly in the production logs.
Client & Insurance Carrier Communication:
Proactively communicate with insurance carriers to inquire about the status of pending claims or resolve issues with denied claims.
Address inquiries from clients or insurance carriers and ensure any issues are addressed quickly.
Document all communication clearly and maintain detailed logs of all calls and emails.
Meeting Performance Metrics & Targets:
Ensure that all assigned claims are followed up within the required timeframes to meet daily and monthly productivity targets.
Meet the client-specific productivity and quality standards related to AR activities, such as claims follow-up and resolution timelines.
Achieve target collections and ensure timely resolution of issues.
Reporting & Escalations:
Prepare and maintain regular status reports on claim statuses, follow-ups, and resolutions.
Ensure that issues that cannot be resolved independently are escalated to the appropriate team or supervisor.
Ensure that all unresolved issues are tracked and followed up with relevant stakeholders to ensure resolution.
Process Adherence & Continuous Improvement:
Follow established procedures for AR activities and ensure compliance with company policies, client requirements, and industry standards.
Continuously look for opportunities to improve processes and streamline AR activities for better productivity and efficiency.
Participate in training and workshops to stay up-to-date on best practices and updates in AR management.
Desired Profile:
Experience:
Minimum 1-3 years of experience in Accounts Receivable, healthcare billing, or a similar field.
Previous experience in claims follow-up, denials management, or healthcare revenue cycle is preferred.
Skills and Competencies:
Strong knowledge of healthcare billing and claims processing.
Good communication skills (english), both verbal and written, with the ability to communicate clearly with clients and insurance carriers.
Ability to manage time effectively and meet deadlines while handling multiple tasks.
Strong attention to detail and accuracy in data entry and claims documentation.
Proficiency in Microsoft Excel, AR software, and healthcare billing systems.
Ability to work independently and collaboratively within a team environment.
Education:
Bachelor's degree in Finance, Accounting, Business Administration, or a related field.
Certification in healthcare billing or AR management (e.g., CPC, CCS) is a plus but not required.
Will work on insurance claims - Denails ,Follow ups
Shift Details:
Night Shift / Day Shift
Work Mode:
Work From Office (WFO)
The Process Executive – AR role is crucial in maintaining the flow of claims and ensuring timely collections. The role requires an individual with a good understanding of healthcare billing, effective communication skills, and the ability to meet productivity targets while ensuring a high level of accuracy and customer satisfaction.
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