Lead Associate AR

• Identify inpatient/observation accounts requiring NOA (Notification of Admission)
• Submit notifications via payer portals, EDI, fax, or calls
• Initiate non-clinical authorizations where applicable
• Document reference / authorization numbers in the system
• Track status and perform timely follow-up on pending / rejected submissions
• Ensure compliance with payer timeliness requirements
• Maintain accurate documentation in system notes / billing summary
• To prioritize the pending claims for calling from the aging basket to make a physical call by following the international norms and applicable rules for confidentiality and HIPAA compliance.
• Responsible for working on Denials, Rejections, LOAs to accounts, making required corrections to claims
• Shall understand and abide by the organizations information security policy and protect the confidentiality, integrity and availability of all information assets.
• Shall report incidents related to security of information to concerned authorities.

• NOA submission
• Payer follow-up
• Documentation

• Clinical review / medical necessity
• Level-of-care decisions
• Appeals & physician advisor services

• Medicare FFS
• Self-pay / charity
• Workers Compensation / liability
• Hospice / research
• Other payer-specific exclusions

• NOA Timeliness Compliance (%)
• First-Pass Submission Accuracy
• Denial Prevention Rate
• Productivity (Accounts/Day)
• Follow-Up Turnaround Time (TAT)

• Must be a Graduate
• Strong English spoken communication skills and also required reading and writing
• Must have 4 + yrs of experience in US Healthcare stream in AR
• Willingness to work night shifts
• Typing speeds of 25 WPM or above
• Ability to handle payer communication channels (portals, EDI, fax, calls)
• Detail understanding and documentation of AR follow-up and denial management processes (Preferred NOA skills)

• Experience in MS Office Suite

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