Process Associate/Senior Process Associate - AR Voice with US Healthcare RCM Experience

About AGS Health

AGS Health is not just a revenue cycle management company; it is a strategic growth partner. Leveraging expert services combined with AI-driven technologies and personalized support, AGS Health stands as the leading revenue cycle collaborator for prominent health systems, physician groups, and academic medical centers across the United States. Their global workforce exceeds 12,000 specialists serving over 150 clients spanning various care settings, specialties, and billing platforms.

Job Role and Responsibilities

• Possess between 1 to 4 years of experience in US Healthcare Revenue Cycle Management, emphasizing underpayment recovery.
• Serve as a Subject Matter Expert and an escalation contact for complicated, high-value underpayment cases.
• Conduct sophisticated underpayment analytics, identify trends, and perform root cause analysis.
• Demonstrate expertise in managed care contracts, including DRG, APC, Per Diem, percentage of charge models, stop-loss clauses, and carve-outs.
• Manage appeal strategies and governance by implementing payer-specific escalation procedures.
• Review and approve intricate appeals, ensuring compliance and timely submission.
• Assist and guide underpayment specialists, developing standard operating procedures and training manuals.
• Verify contract build accuracy and detect issues related to payer adjudication.
• Generate, comprehend, and analyze Expected vs Paid and variance reports.
• Enhance recovery performance using data-driven insights and process optimizations.

Process Details

This role involves International Voice Process with a focus on AR Calling.

Qualifications and Skills Required

• Intermediate, Graduate, or Postgraduate qualification is acceptable.
• Minimum of 1 to 3 years in AR calling, specifically handling Denial Management related to physician billing.
• Comfortable working in night shifts (5:00 PM to 2:00 AM or 6:30 PM to 3:30 AM) corresponding to US shift hours with shift flexibility.
• Good communication skills in English.
• Immediate joiners preferred.

Work Details and Benefits

• Employment type: Full-time, regular, permanent role.
• Office-based role at 9th Floor, Western Pearl Building, Survey No. 13, Kondapur, Kothaguda, Hyderabad, Telangana 500084.
• Five working days per week.
• Provision of two-way transport within boundary limits.
• Employee benefits include Provident Fund (PF), Employee State Insurance (ESI), health insurance, and performance bonuses.

Interview Process

• Two rounds of face-to-face interviews.
• Initial online assessment followed by operational and technical rounds.