Optum Global Solutions
Website:
optum.in
Job details:
Responsibilities
This position requires
experienced candidate. The AR Associate is responsible for the accounts receivable aspects of the client-focused revenue cycle operations and must display in-depth knowledge of and execute all standard operating procedures (SOPs) as well as communicating issues, trends, concerns and suggestions to leadership.
Required Skillset:-
- Responsible for the accurate processing and completion of medical claims.
- Process claims, that route out of automatic adjudication, within current turnaround standards.
- Proficiency in product lines applicable to processing unit.
- Ability to understand and apply plan concepts to include:
- Deductible
- Coinsurance
- Copay
- Out-of-pocket
- Maximums, inside limits and exclusions
- State variations
- Recognize issues related to variable deductible, coordination of benefits, carve-out and alternate benefits.
- Adhere to quality improvement initiatives
- Demonstrate increasing productivity to meet minimum requirements while maintaining quality standards
- Special Projects as required
Qualification and Work Experience
- Graduate
- 12+ months and above experience in healthcare accounts receivable (Denial Management)
- Functional knowledge of HIPAA rules and regulations and experience related to privacy laws, access and release of information
- Solid knowledge of medical insurance (HMO, PPO, Medicare, Medicaid, Private Payers)
- In-depth working knowledge of the various applications associated with the workflows
- Solid knowledge and use of the American English language skills with neutral accent
- Proficient in MS Office software; particularly Excel and Outlook
- Proven ability to communicate effectively with all internal and external clients
- Proven ability to use good judgment and critical thinking skills; ability to identify and resolve problems
- Proven efficient and accurate keyboard/typing skills
- Proven solid work ethic and a high level of professionalism with a commitment to client/patient satisfaction
Skills Required
ü Good Communication Skills.
ü Well versed with MS Office and PC Skills.
ü High productivity and Quality benchmark.
ü Good Analytical abilities and Detail oriented.
ü Process adherence orientation.
ü Ability to work with minimum supervision.
ü Open to work in shifts (evening).
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