Job Summary

The Senior Process Associate plays a crucial role in the Delivery Operation team by ensuring accurate medical billing and credentialing services. This position focuses on facilitating effective communication with healthcare payors to secure timely reimbursements while maintaining high-quality customer interactions and optimizing operational workflows. Knowlege of HIPAA, HIPAA HITECH, PI, PHI

Key Responsibilities

1. Direct The Resolution Of Customer Queries And Issues Related To Medical Billing Via Written Communication, Ensuring Swift And Effective Responses By Utilizing Medical Billing Software And Healthcare Regulations Knowledge.
2. Manage Troubleshooting Tasks In The Billing Process, Providing Effective Solutions For Claims Denials And Escalations To Higher Levels Of Support When Necessary To Enhance Service Delivery.
3. Evaluate Operational Workflows In The Medical Billing Process, Identifying Inefficiencies And Suggesting Enhancements For Improvement Using Process Mapping Tools And Data Analysis Techniques.
4. Ensure The Quality And Precision Of Processed Medical Billing Data And Customer Interactions By Adhering To Established Compliance Standards And Conducting Regular Audits.
5. Oversee The Accurate Entry, Updating, And Management Of Patient Data Across Multiple Healthcare Databases, Ensuring Compliance With Us Healthcare Regulations And Internal Policies.

Skill Requirements

1. Proficient Understanding Of Medical Billing And Credentialing Services
2. Basic Knowledge Of Healthcare Regulations And Compliance Standards
3. Strong Written And Verbal Communication Skills In A Customer Support Context
4. Team Orientation With The Ability To Collaboratively Resolve Issues And Enhance Processes
5. Familiarity With Data Management Tools And Operational Workflow Analysis
6. Good Knowledge On Denials, Autoriztion, Cpt, Hcps, Icd-10, Timely Filling, Tat, Work Prioritization
7. Good Knowledge On Working With Standard Claims Forms(Cms & Ub) & Non Standard
8. Good Knowlege On Charge Entry, Payment Posting

Other Requirements

1. Optional But Valuable Certifications In Medical Billing And Coding (Cpc, Cca) Or Healthcare Compliance (Chc)