TruBridge
Healthcare Insurance • SaaS • Finance
TruBridge is a healthcare solutions company specializing in revenue cycle management, electronic health records, patient access and engagement, and enterprise resource planning for healthcare providers. The company offers comprehensive, customizable services to hospitals, clinics, and ambulatory care facilities, aiming to improve financial health and operational efficiency. TruBridge's solutions include coding technology services, population health and data management, and outsourced revenue cycle management services. Their focus on data-driven insights and innovative products helps eliminate financial and operational obstacles, laying a foundation for long-term success in the healthcare industry.
Account Receivables Analyst, Ambulatory
Job not on LinkedIn
August 12
TruBridge
Healthcare Insurance • SaaS • Finance
TruBridge is a healthcare solutions company specializing in revenue cycle management, electronic health records, patient access and engagement, and enterprise resource planning for healthcare providers. The company offers comprehensive, customizable services to hospitals, clinics, and ambulatory care facilities, aiming to improve financial health and operational efficiency. TruBridge's solutions include coding technology services, population health and data management, and outsourced revenue cycle management services. Their focus on data-driven insights and innovative products helps eliminate financial and operational obstacles, laying a foundation for long-term success in the healthcare industry.
📋 Description
• Claim processing and submission. • Submit the claim to insurance companies to receive payment for services rendered by a healthcare provider. • Taking denial status from various insurance carriers • Checking eligibility and verification of policy • Analysis of the data • Converting denials into payments • Follow Health Insurance Portability and Accountability Act (HIPAA) • Account follow up on fresh claims, denials, and appeals. • Checking the claim status as per their suspension and denials • Achieving weekly/monthly production and audit target • Record after-call actions and perform post-call analysis for the claim follow-up. • Provide accurate information to the insurance company, research available documentation including authorization, physician notes, medical documentation on PM system, interpret explanation of benefits received, etc.
🎯 Requirements
• 3 Years of experience in accounts receivable follow-up/denial management for US healthcare. • Mandate Ambulatory experience of 3 years. • Candidate should have hands on experience in CMS-1500 Billing- Professional Billing experience. • Candidate should have knowledge of appeals process of various US Healthcare insurance companies. • Perform pre-call analysis and check the status by calling the payer or using IVR or web portal services. • Maintain adequate documentation on the client software to send the necessary documentation to insurance companies and maintain a clear audit trail for future reference. • Record after-call actions and perform post-call analysis for the claim follow-up. • Provide accurate information to the insurance company, research available documentation including authorization, physician notes, medical documentation on PM system, interpret explanation of benefits received, etc. prior to making the call. • Perform analysis of accounts receivable data and understand the reasons for underpayment, days in A/R, top denial reasons, use appropriate codes to be used in documentation of the reasons for denials/underpayments. • Comply with all reimbursement and billing procedures for regulatory, third party, and insurance compliance norms. • Responsible for meeting daily/weekly productivity and quality reasonable work expectations.
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