Job Openings at JV Healthcare Solution​

Department – AR Operations

Essential Functions:

• Prepare and submit clean claims to various insurance companies electronically or by paper.
• Answers questions from patients, front office, and insurance companies.
• Identifies and resolves patient billing complaints.
• Prepares, reviews and sends patient statements
• Follows and reports the status of delinquent accounts.
• Review and support payment posting from insurance companies and patients.
• Participates in educational activities and attends weekly and monthly staff meetings.
• Manage a team of billing specialists that supports the account.
• Conducts self in accordance with organization’s employee manual.
• Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.

Skills/Experience:

• Experience of 6 -8 years in Revenue Cycle Healthcare Operations in a managerial role. (Assistant Manager & Above)
• Experience in handling both DATA (Demo, Charges, Payment Posting) and VOICE Processes (AR Follow-up) with practical knowledge of each process.
• Should have handled a team of a minimum of 25+ Employees
• Should have good knowledge of operations planning techniques and good execution capabilities.
• Proficiency with eCW is an added advantages
• Ability to establish and maintain effective working relationships with clients, patients and coworkers.
• Must be well organized and detail-oriented.
• Must maintain a professional etiquette, team player and goal-oriented.

Shift Timings – 6.30 pm to 3.30 am.

Reporting to – Manager – AR Operations

Operational Responsibilities

• Manage a team of 25-30 members
• Responsible for the day-to-day functional supervision of the work group, including work assignment and attendance monitoring; providing input into selecting, training, developing, and completing performance appraisal of work group(s) in accordance with the organization’s policies and applicable compliance requirements.
• Provide subject matter expertise to QC Analysts in the team
• Review reports on a daily basis and provide constructive feedback
• Ensure training needs of subordinates are met
• Adjust to the needs of meeting SLA under the supervision of Manager
• Communicate all process and client changes to direct reports within specific timelines and keep record for such updates
• Knowledge of Speciality billing with experience in Transplant/Gift Of Life/Organ Procurement billing and follow-up, identify the right changes and billing the same to the specific Organ procurement will be added advantage

Team Performance / Disciplinary Issues

• Monitor, identify and resolve performance/behavior/attendance issues
• Monitor and take action on personnel and disciplinary issues
• Successfully complete all client related training and keep record of the same
• Resolve escalated customer issues and CAPA to be taken
• Hold team briefings on a daily basis with the team (Max of 15 mins)
• Escalate performance-related issues with respect to assigned team members to Managers on a timely manner (PIP)

• Eligibility

• Graduates / Diploma holders with excellent communication skills
• Minimum 5 years of experience in US Healthcare AR Domain
• Should have good knowledge of Hospital / Physician Billing, AR Follow Ups, Denial Management
• Good Client coordination skills
• Good knowledge in MS Office, Data Analysis & report generations
• Good people management skills
• Should be willing to Work-From-Office and work in US time zones

Key Responsibilities

• Meet Quality and productivity standards.
• Contact insurance companies for further explanation of denials & underpayments.
• Experience working with multiple denials is required.
• Take appropriate action on claims to guarantee resolution.
• Ensure accurate & timely follow-up where required.
• Should be thorough with all AR Cycles and AR Scenarios.
• Should have worked on appeals, refiling, and denial management

Mandatory Skills

• Excellent written and oral communication skills.
• Minimum 1-year experience in AR calling
• Understand the Revenue Cycle Management (RCM) of US Healthcare providers.
• Basic knowledge of Denials and immediate action to resolve them.
• Follow up on the claims for collection of payment.
• Responsible for calling insurance companies in the USA on behalf of doctors/physicians and following up on outstanding accounts receivables.
• Should be able to resolve billing issues that have resulted in payment delays.
• Must be spontaneous and enthusiastic
• Experience in eClinicalWorks

Demo & Charge Entry Specialist – Physician Billing

• Enter patient demographic and insurance information accurately into the billing system.
• Review physician documentation to accurately code and enter charges for services provided.
• Verify insurance coverage and obtain necessary authorizations for billing.
• Ensure compliance with all healthcare regulations and guidelines related to billing practices.
• Resolve billing discrepancies and issues with insurance companies or patients as needed.
• Communicate effectively with physicians, office staff, and patients regarding billing inquiries.
• Maintain confidentiality of patient information in accordance with HIPAA regulations.
• Assist with month-end closing processes and reconciliation of accounts.

Experience:

• Minimum 2 years of experience in US Medical Billing is required.
• Industry-leading remuneration package.
• Immediate placement for selected candidates.
• Preference for immediate joiners.
• Strong proficiency in Medical Billing (Demo & Charge) is essential.

Skills & Experience

Be familiar with HIPAA and PHI guidelines.

Job description

• Manage credentialing for healthcare providers, ensuring accurate and timely processing.
• Verify provider credentials, licenses, and certifications for compliance.
• Coordinate with insurance companies to enroll providers and resolve enrollment issues.
• Maintain and update provider information in the RCM system.
• Monitor enrollment statuses and track changes in insurance plans and regulations.
• Maintain accurate provider profiles on CAQH, PECOS, NPPES, and CMS databases.
• Should have excellent knowledge in Group Medicare and Medicaid Enrollment/Contracts along with commercial insurances.

Job Requirement:

• Bachelor’s degree in any discipline.
• Minimum of 1 to 3 years of experience working in healthcare credentialing, preferably in a medical billing or revenue cycle management setting.
• Manage all aspects of the provider enrollment and credentialing process, including initial applications, re-credentialing and maintaining provider information in all necessary systems.
• Excellent communication in English, both written and oral.
• Willing to work the night shift (any 9 hrs. between 6:30 pm 3:30 am)
• Salary: as per company policy

Job description

• Responsible for researching patient member benefits, additional coverages, coverage limitations, and general coverage allowances to obtain the necessary authorizations and referrals for patient services.
• Initiate and manage the prior authorization process for medical procedures, treatments, or medications.
• Prepare and submit prior authorization requests to insurance companies or healthcare payers according to established procedures.
• Ensure all required documentation, including clinical notes, medical history, and supporting documents, are complete and accurate.
• Processes prior authorizations and referral requests in a timely manner, prior to the patient’s services being rendered.

Job Requirement:

• Bachelor’s degree in any discipline.
• Min 1 year experience in Pre-Authorization & eligibility, benefits
• Strong knowledge of medical terminology, insurance policies, and healthcare reimbursement processes.
• Excellent communication, organizational, and problem-solving skills.
• Ability to work independently and collaboratively in a fast-paced, deadline-driven environment.
• eClinicalWorks experience will be an added advantage.
• Willing to work the night shift (any 9 hrs. between 6:30 pm 3:30 am)
• Salary: as per company policy