SMARTER TECHNOLOGIES LLC

Discussion

Revenue Cycle Analyst - Voice

Summary

Handles US healthcare billing calls with payers, providers, and patients to resolve claims, eligibility, and payment issues while ensuring compliance and documentation standards.

Job Summary:

We are seeking experienced and customer-focused Revenue Cycle Associates to support our US Healthcare Revenue Cycle Management (RCM) voice operations. The ideal candidate will have hands-on experience interacting with insurance payers, healthcare providers, and patients to resolve billing and claims-related issues. This role requires excellent communication skills, strong knowledge of the US healthcare reimbursement process, and the ability to resolve issues efficiently while maintaining high standards of compliance, quality, and customer service.

Supervisory Responsibilities:

This position has no direct supervisory responsibilities.

Duties/Responsibilities:

  • Contact insurance companies, healthcare providers, and patients to resolve claim, billing, eligibility, authorization, payment, and denial-related issues.

  • Make and receive professional outbound and inbound calls while adhering to client and regulatory guidelines.

  • Research unpaid, underpaid, denied, or rejected claims and take appropriate action for resolution.

  • Verify insurance eligibility, benefits, claim status, prior authorizations, and payment information.

  • Analyze payer responses and determine the next appropriate course of action, including claim corrections, resubmissions, or appeals.

  • Document all call activities accurately in client systems and maintain complete account notes.

  • Utilize payer portals and practice management systems to support account resolution.

  • Meet productivity, quality, and service level expectations while maintaining high call quality standards.

  • Escalate complex issues appropriately to supervisors or client contacts.

  • Participate in induction, client-specific training, refresher programs, and continuous learning initiatives.

  • Identify process improvement opportunities and proactively contribute to operational excellence.

  • Ensure compliance with HIPAA, client requirements, and organizational policies.

  • Performs other duties as assigned.

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