Subject Matter Expert - SME
Job Title: Subject Matter Expert - Account Receivables
Years of Experience: 4–5 Years
Shift Timings: Night Shift (7:00 PM to 4:00 AM)
Location: Hyderabad, Telangana
Roles and Responsibilities:
AR callers with good experience of 4+ Years RCM Experience (Physician Billing).
Knowledge of Federal, Commercial, and WC Payor Requirements
Understanding provider information and patient information as it impacts claim resolution
Knowledge of Clearing House rejections or denials and its resolution
Knowledge of Payor Denials and Resolution
Knowledge of Appeals Process: Form Types and Documents related to Appeals, Online Appeals
Coding knowledge: ICD/CPT, E/M codes, Code Series, Modifiers in Physician billing, and its impact
Good IQ levels understanding the denials and timely resolutions.
Agents should have high task capabilities to work on Client analytics, High dollar claims, Rejections, Report management and maintaining Team metrics.
Demonstrate deep knowledge of Accounts Receivable and specialized experience in AR-Denial management.
Address and resolve complex AR-related issues, acting as the go-to resource for technical and process queries.
Guide and train AR teams for continuous performance and mentoring.
Strong analytical, problem-solving, and technical capabilities; excellent communication skills; and strong data analysis competencies.
Ability to customize training needs to meet the business requirements for specific practices/specialities
Ability to handle complex denials and strong determination to provide resolution on denials.
Education Qualification:
Any graduate