Process Associate

To address outstanding or assigned AR through trend analysis – ability to spot a pattern or trend over a period of time (using available data elements) and phone calls by using available resources
Denial Resolution – Ability to research and analyze available information (from document management system, practice management system, payer website etc.) to resolve claims(resulting in a payment, corrected claim submission, appeals, patient transfer, secondary billing and / or adjustment) by utilization of all possible tools and application
To report trends / patterns in denials, claim submission errors, credentialing issues and billing related road blocks to the reporting manager
To apply logical reasoning and analytical thinking – visualize, articulate and solve complex tasks based on available information
To do basic Root Cause Analysis (ability to identify the underlying cause to a particular problem) and suggest methods on fixing it permanently
To meet the established SLAs (service level agreements) for production and quality
To update the outcome of the calls or analysis in a clear and coherent manner (articulate findings, issues, conclusions) in the billing system
To utilize the P & P’s (policies and procedures) established for the process and also stay updated with changes done with the P & Ps
To improve the performance based on the feedback provided by the reporting manager / quality audit team
AGS Health
Chennai, TN, IN