Accounts Receivable Specialist

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Richard Scott

Accounts Receivable Specialist

Summary

Skilled in AR Management, Customer Service and Training. A hard working professional with 3 years of experience in end to end projects on Revenue Cycle Management, i.e. eligibility and benefit verification, charge entry, Denials Management, Claims Rejections, Claims Recoupments/Refunds, Obtaining prior Authorizations. Claim Appeals, Claim Reconsideration Letters, Correspondence analysis etc. 

Skills

  • Heathcare
  • RCM
  • Medicare
  • AR Calling

Work Experience

Sr. AR Analyst

Nath Outsourcing Solutions Pvt. Ltd.

Present

Nath Outsourcing Solutions Pvt. Ltd. (NOS) was established in 2003 with a vision to provide end to end solutions to our clients in the US Healthcare Industry

  • Handling client account
  • Working on failed and rejected claims.
  • Part of client review for various accounts on monthly basis.
  • Attending the call from Onshore team to discuss the daily trends and issues in processing the claims.
  • Maintain communication with Payers (Insurance) via telephone or payer website if we need any information regarding the claim like check#, date of payment etc.

AR Analyst

R1 RCM (formerly Accretive Health)

Aug 2019

R1 RCM (formerly Accretive Health) is a leading provider of revenue cycle services and physician advisory services to healthcare providers. We help transform and manage the commercial infrastructure of care organizations throughout the U.S.A.

Job Profile:

  • Inducting different micro level processes of RCM like AR follow up ,Denial Management, ERA (electronic remittance advice) management,Appeal and Grievance.
  • Worked in Athena management Software
  • Focus on resolving the denial and rejection rather than writing off the amount.
  • Priority to high dollars and sensitive case for those whose TFL about to expire.
  • Work for provider’s based billing ,somehow any issue raised in billed claims then
  • Recreate the claim again with correct info and void the previous claim
  • Client interaction on weekly,monthly and Quarterly basis regarding the workflow

Process Associate

Genpact

Sep 2018

 

  • Receive and verify requests for prior authorizations and ensure that they are administered properly.
  • Consult with presiding doctors or nurse managers to obtain clearance for the necessity of treatment
  • Look through insurance plans in a detailed manner and process required referrals
  • Sort medical records and submit them to the carrier in a bid to expedite the authorization process
  • Keep medical staff in the loop about any delays or problems in obtaining authorizations
  • Ascertain that insurance carriers’ documentation requirements are completed and that all copies are placed in patients medical records files

Education

BBA

San Jose State University


Languages

  • English
  • French
  • Arabic
  • German

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