Location
Pune | India
Job description
Welcome to Veradigm! Our Mission is to be the most trusted provider of innovative solutions that empower all stakeholders across the healthcare continuum to deliver world-class outcomes. Our Vision is a Connected Community of Health that spans continents and borders. With the largest community of clients in healthcare, Veradigm is able to deliver an integrated platform of clinical, financial, connectivity and information solutions to facilitate enhanced collaboration and exchange of critical patient information.
Veradigm Veradigm is here to transform health, insightfully. Veradigm delivers a unique combination of point-of-care clinical and financial solutions, a commitment to open interoperability, a large and diverse healthcare provider footprint, along with industry proven expert insights. We are dedicated to simplifying the complicated healthcare system with next-generation technology and solutions, transforming healthcare from the point-of-patient care to everyday life.
For more information, please explore Veradigm.com.
What will your job look like: Job Summary Responsible to know and facilitate specific accounts and their unique attributes in order to successfully provide customized RCM for each account. This is a dual position with its own workload along with oversight to train, audit and monitor the group for accurate procedures and turnaround. Ensure workflow, including collecting payments stays current and on track with regards to insurance carriers, patients, clients and internal interactions. Supports the overall
Operations and Client Services by efficiently and effectively providing and reviewing account data needed for the Revenue Cycle process and delivering results.
Essential Functions/Major Job Responsibilities - Strong customer service skills for client satisfaction, health of client AR and guidance for RCM team members
- Answers client calls; prompt return and follow up to all interactions; prompt response to requests for information, both internally and externally.
- Acts as initial point person for team regarding technical work questions/processes/procedures to provide training/guidance.
- Escalates issues to RCM Management related to clients and staff.
- Trains individuals on systems and workflow in order to ensure protocols are followed.
- Reviews and works all unpaid and denied insurance correspondence, both phone appeals and written appeals; confirm all patient and insurance is current and up to date.
- Runs, reviews and works unpaid patient balance reports for payment by reading current notes and place for past due letters and phone calls.
- Prepares insurance/patient correspondence for coworkers by reviewing and batching for further attention and review.
- Prepares and sends uncollected patient payments to collections by writing up forms for the doctors to review.
- Reviews and works insurance and patient overpayments, prepare refund request and send to doctor's office.
- Answers phone calls from insurances and patients.
- Organizes, identifies and improves workflow with team members/Management through daily and weekly productivity reports and reports challenges and concerns and requests need for assistance to RCM Management.
- Ability to perform the duties of the Payment Entry Specialist, Charge Entry Specialist, AR Specialist and RCM Specialist roles.
- Keeps manager informed of progress, achievements and issues; assist staff with processes, information and workload.
- Achieve goals set by management and compliance requirements.
- Follows, and models adherence to all policies, procedures and processes.
- Other duties as assigned.
An Ideal Candidate will have:
Education
- Bachelor's degree or equivalent preferred.
Work Experience
- 3-5 years of relevant work experience in RCM AR preferred.
Working Arrangements
Shift Timing
- Evening Shift (8:30 PM IST to 5:30 AM IST)
Knowledge, Skills, And Abilities - Knowledgeable of CPT and ICD coding and medical terminology
- Extensive knowledge with email, search engines, Internet, ability to effectively use payer websites and Laserfiche; basic competence in use of Microsoft products.
- Preferred experience with MS Access and PowerPoint, Crystal reports and various billing systems, such as NextGen, Pro, Allscripts, Epic and others
- Knowledge of CPT, ICD10 and modifiers.
- Experience in specialties such as Psychiatry, Internal Medicine, Orthopedics, General Surgery
- Familiar with HMO and IPAs, Medicare Fee for Service Plans and Commercial Payers
- Prior experience on Allscripts PM is a plus.
- Strong communication skills
Benefits Veradigm believes in empowering our associates with the tools and flexibility to bring the best version of themselves to work. Through our generous benefits package with an emphasis on work/life balance, we give our employees the opportunity to allow their careers to flourish.
- Quarterly Company-Wide Recharge Days
- Flexible Work Environment (Remote/Hybrid Options)
- Peer-based incentive 'Cheer' awards
- 'All in to Win' bonus Program
- Tuition Reimbursement Program
To know more about the benefits and culture at Veradigm, please visit the links mentioned below: -
We are an Equal Opportunity Employer. No job applicant or employee shall receive less favorable treatment or be disadvantaged because of their gender, marital or family status, color, race, ethnic origin, religion, disability or age; nor be subject to less favorable treatment or be disadvantaged on any other basis prohibited by applicable law.
Veradigm is proud to be an equal opportunity workplace dedicated to pursuing and hiring a diverse and inclusive workforce.
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