EXL—Senior Executive - Operations

Job description

Description: PROFESSIONAL: - Recognize and respect cultural diversity. - Adapt communication to an individual’s ability to understand. • Use medical terminology appropriately. - Respond to communications received within a reasonable time frame. - Project a professional manner and image. - Adhere to ethical principles. - Demonstrate initiative and responsibility. - Work as a team member. - Efficient Time Management. - Prioritize and perform multiple tasks. - Adapt to change, including new hours of operation and methodology. - Attend functional team meetings and mandatory in-service education. - Maintain proper observation and adherence to company policies and procedures. Requirements: - REQUIRED EDUCATION/EXPERIENCE: Graduate in any stream; customer service; must be computer literate; have multi-tasking skills, excellent organizational skills, verbal and written communication skills; team player. YEARS OF EXPERIENCE: - 2-5 Years for A2 Band POSITION RELATIONSHIPS: - Reports directly to the Assistant Manager KNOWLEDGE, SKILLS, AND EXPERIENCE: - Good organizational skills and the ability to multi-task - Ability to operate basic office equipment, answer multi-line telephones, and have a strong computer background. - Establish and maintain effective working relationships with patients, insurance companies, and staff. - Good written and oral communications. - Knowledge and skills in working with computerized billing systems including practice management software and EMR. - Must adhere to all HIPAA guidelines and regulations. - Knowledge of medical insurance and authorization processes. - Some medical terminology and experience working in a healthcare or insurance environment. LEGAL and COMPLIANCE: - Maintain patient and company confidentiality. - Practice within the scope of education, training, and personal capabilities. - Document company documents (hard copy and electronic) accurately. - Use appropriate guidelines for releasing information. - Maintain awareness of US federal and US state health care legislation and regulations, PHI, HIPAA WORKING HOURS: - 40 hours per week as Full-time employee - Shift time: 7:30 PM IST - 4:30 AM IST - Weekends Off TELECOMMUTER/INTERNET REQUIREMENT: - High Speed internet connection at home, must be broadband with minimum of 100 MBPS Speed or above - Must understand and adhere with telecommuter policy - Must have power backup at to mitigate power outage Responsibilities: - Interact and probe the insurance representative to get the required status update and have the claim resolved - Ensure Daily Productivity targets are met at the required quality level on the assigned inventory, - Perform timely follow up on claims to avoid revenue loss, Prioritize the pending claims for calling from the aging bucket, - Review claims that have not been paid by insurance companies, - Check insurance information provided by patient if it is insufficient or unclear, - Follow the guidelines and applicable rules while calling insurance companies for confidentiality and HIPAA compliance, - Escalate difficult collection situations to management in a timely manner, Handling patients billing queries and updating their account information, - Post cash and write off the contractual adjustments accordingly while working on the accounts, - Meeting daily/weekly and monthly targets set for an individual