Operation analyst | senior operation analyst – DM & OCF

Key responsibilities include

1. Daily production carried out efficiently according to the daily production targets specified by management.
2. Generate denial reports, analyze and work based on priority levels.
3. Download/ verify correspondences from Box folder/ SFTP/ HER to fix denied claims.
4. Ensure daily allocated denials are fixed as expected and submit report to the management.
5. Ensure proper analysis being done before reaching out to other stakeholders and resolve internal gaps are identified eliminated.
6. Develop denial and AR root cause analysis and share with management review.
7. Ensure 30 plus paid rate is achieved as expected for the assigned client/s.
8. Ensure QA reports are reviewed, fixed and responded back to the QA teams within 24 hours.
9. Ensure to responded back to all internal e-mails within the shift time.
10. Enforce company regulatory standards to ensure the area of responsibility is in compliance with HIPPA and ISO standards.
11. Ensure to respond back to all internal e-mails within the shift time.
12. Daily and weekly assigned reports to be shared within the given timelines.
13. Ensure other functions are notified on identified denial trending to avoid repetitive denials and provide new instructions to update SOPs in a timely manner.
14. Ensure to update SOPs in a timely manner and according to the required level.
15. Conduct random QA on a percentage decided by the management.
16. Perform QA daily if allocated and ensure to share QA reports with the relevant personnel.
17. Denial fixes quality to be maintained at 98% accuracy or greater.
18. AR follow up to be maintained at 98% accuracy or greater.
19. Conduct training to newcomers on the job specific functions.

Qualifications/criteria

1. Bachelor’s degree in finance, healthcare, business, or related field.
2. Minimum 1 to 2 years in RCM experience.
3. Minimum 1 + years in DM/OCF experience.
4. Passion for solving problems.
5. Ability to work with MS Office package.
6. Good written and verbal communication skills.
7. Ability to work under pressure.
8. Tenacity.

Other details

1. Work week: Monday to Friday
2. Shift: 7.30PM to 4.00AM (night shift)
3. Other details: US calendar applicable

About the company

HealthRecon Connect® provides technology-enabled revenue cycle management solutions to US healthcare providers. The company leverages over 30 years of deep domain expertise, machine learning, AI, cutting-edge analytics, and automated workflows that help improve cash flow, patient outcomes, and enable peace of mind for their clients. At HealthRecon Connect, day after day, we not only hold ourselves accountable for setting and maintaining high standards, but we also passionately strive for the highest achievement, customer delight, and thrive on the challenge of high expectations and commitment to excel.

HealthRecon was certified a Great Place to Work® by Great Place to Work® in Sri Lanka for five consecutive years and was adjudged one of the 40 Best Workplaces in Sri Lanka in 2021. HealthRecon is also a participant in the United Nations Global Compact.

HealthRecon Connect is an equal opportunity employer.

When applying

To apply, kindly send your CV to [email protected], using the subject line “OA/SOA DM & OCF.” Your application would not be considered without a CV on file. Please review the criteria and other information listed on this job advertisement thoroughly prior to applying. Please pay specific attention to the workweek, shift details, and other features of the job. All applications will be reviewed in the order in which they were received and only the candidates short-listed for the first round of interviews will be contacted due to the large volume of applications we receive. Thank you for understanding.