Senior Associate AR

Job Family:

EBO Accounts Receivable (India)

Travel Required:

None

Clearance Required:

None

What You Will Do:

• 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, LOA's 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.

Scope & Boundaries:

Included:

• NOA submission
• Payer follow-up
• Documentation

Excluded:

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

Account Exclusions (as per SOP):

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

Key KPIs:

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

What You Will Need:

• Must be a Graduate
• Strong English spoken communication skills and also required reading and writing

• Must have 2 + 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)

What Would Be Nice To Have:

• Experience in MS Office Suite

What We Offer:

Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.

About Guidehouse

Guidehouse is an Equal Opportunity Employer–Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.

Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.

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