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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in managing and resolving healthcare accounts receivable claims while ensuring compliance with HIPAA regulations. Proficient in analyzing outstanding receivables and meeting productivity targets in a fast-paced environment.
Highest-signal resume keywords
Healthcare Accounts Receivable ProcessUS Healthcare AR ExperienceExcellent Written Communication SkillsExcellent Oral Communication SkillsComputer Literacy
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Industry Keywords
Outstanding ReceivablesClaims ResolutionService Level AgreementsPatient Billing QueriesInsurance CompaniesConfidentialityHIPAA ComplianceDemographic DenialsEligibility DenialsBPO Experience
About the role
Key responsibilities & impact- Review and analyze the assigned outstanding receivables portfolio to identify unresolved claims
- Manage and resolve outstanding and denied claims by coordinating with insurance companies
- Follow up to obtain additional information required for claim resolution
- Resolve claims within established timelines and defined Service Level Agreements (SLAs)
- Perform website checks and handle non-callable denials
- Work on website-related claims based on coding team responses
- Work all non-callable, demographic, and eligibility denials
- Meet daily productivity targets at the required quality level
- Follow up on claims and prioritize pending claims from aging buckets to avoid revenue loss
- Review claims not paid by insurance companies
- Check insufficient or unclear patient insurance information
- Escalate difficult collection situations to management
- Handle patient billing queries and update account information
- Post cash and write off contractual adjustments
- Meet daily, weekly, and monthly individual targets
Requirements
What you’ll need- Graduation in any stream
- 3-6 years of BPO experience
- US Healthcare AR experience preferred
- Excellent written (documentation) and oral communication skills
- Computer Literacy
- Healthcare Accounts Receivable Process
- Follow guidelines and applicable rules while calling insurance companies for confidentiality and HIPAA compliance
