Role : AM - Payer Specialist 

Location : Turbhe, Navi Mumbai/ HighTech – Hyderabad

Skills required: 

1. Knowledge on End-to-End RCM 
2. Basic knowledge on coding & Billing 
3. Extensive knowledge on all payers , rule, updates, policy 
4. Excellent communication – Oral and Written 
5. Working knowledge of Excel and other Microsoft tools 
6. Must have worked in AR /Billing with Minimum exp of 5 to 6 Yrs 
7. Previous payor specialist experience is preferable 

Eligibility: 

8. Graduate from any stream 
9. Willing to work in US Shift 

Duties of the Job: 

10. Should be able to generate the reports from system and do an extensive analyze on the data and provide guidance to the OPS team based on the data analyst. 
11. To review and analyze the payor denials and work with payor relation representative to create a project and get the claims reimbursed globally 
12. To update the team on the payor updates on policy , rules , LCD/NCD, changes. 
13. Work closely with OPS team to do regular review on the process updates, review data 
14. Assisting OPS team to resolve the denials and reduce AR by providing the next step action required as per the payor policy 
15. Dedicated follow_up on the project created with payor relation and update the ops team on the progress 
16. Interaction with clients on the payor level issues/denials 
17. Guide ops team on JOC project with client and interact with client on the same 

It is an IC role.