Job Openings at 4D Global

• Responsible for calling US insurance companies on behalf of Physician/Medical Billing
• Reviewing EOB, capturing denials, fixing them for payments, and understanding recoupment.
• Able to resolve billing issues.
• Appropriate action for denied claims.
• Knowledge of denials, appeals & referrals.
• Good knowledge of the complete RCM process.

• Minimum 1 year experience in AR Calling
• Should have a very strong verbal and written communication skill with the ability to speak confidently and interact with the insurance representatives on the phone calls with confidentiality and following the HIPAA compliance.

• Reviewing EOB’S.
• Manual posting and auto posting
• Identify denial codes (RARC & CARC) with denial reason & Correspondence.
• Post checks to the correct patients
• HSA and HRA Payments
• Adjustments and write off scenario , if patient’s secondary is Medicaid

• Minimum 1 year experience in Payment Posting
• Good typing skills
• Knowledge in payment formulas ,co-pay,co-insurance and deductibles

• Client Maintenance
• Project based updates to ensure client’s demographic information remains current with the insurances, Including but not limited to: Change of Address updates, ownership, EFT, Liscence Updates, Name updates
• Enrolling providers with the insurances by preparing enrollment application
• Being current on the accurate applications to be sent to each payer
• Utilize NHI system to determine if the enrollment can be pursued based on the specific client and payer requirements
• Communication to the enrollment team regarding resolution and updates with payers
• Identify and forward potential payer updates based on corrections and/or returned applications to ensure future applications are not returned for the same reason
• Form maintenance for all enrollment related forms
• Utilize all resources available to obtain credentials and/or information to prepare enrollment forms and updates
• Prepare formal client requests for signatures and/or additional information
• Web Portal Registration
• Electronic Enrollment: Manage incoming requests for web portal access by completing registration forms

• Should have experience in filling provider applications
• Should know experience using CAQH
• Exposure in handling PECOS and NPPES

• Manage and allocate daily work volumes to ensure client SLAs & TAT are met.
• Assist with production for all client-specific processes.
• Manage day-to-day planning and problem solving related to in-bound work volumes
• Tracked the team member’s work to proactively identify and resolve shortages impacting production plans.
• Development and delivery of routine reports required to monitor and report on team’s performance and provide customer feedback.
• Directly engaging in problem solving on production related issues with team members, as required.
• Coordinated training and mentoring of new team members who joined the project recently.
• Produced regular performance reports and reviews, seeking areas for improved operational efficiency.
• Developing a strong business relationship with the client and analyze the client’s performance are achieved and outcome results are aligned to both Client and Organization goals.

• 6+ Years of Experience in US Healthcare – RCM
• Experience in handling AR Follow-up and Denial Management.
• Experience as TL for atleast 1 year.
• Should have experience of handling 15 to 20 employees.
• Excellent written and verbal communication.
• Excellent interpersonal and collaborative skills.
• Initiator with the ability to lead and own end to end projects.
• Multiple billing platform / software experience will be and added advantage.

Job Description

•  Identify causes for non-achievement of SLAs, develops solutions and executes the same
•  Hands on Client Management Skills
•  Interaction with Client on a regular basis and ability to manage and maintain high customer satisfaction levels with Client Net Promoter Score of 9+
•  A key contributor to process management and improvement
• Responsible for attrition management, arranging for replacements on a timely basis and work closely with HR to ensure high employee morale and retention initiatives

Requirements / Qualification

• Minimum 6+ years experience in Medical Billing
• Excellent ORAL and WRITTEN Communication Skills
• Experience in handling both DATA (Demo, Charges, Payment Posting) and VOICE Processes (AR Follow-up) with practical knowledge of each process
• Should have played a key role in Delivering Projects according to Client SLAs and KPIs

Job Description

• Perform data discovery, analysis, and modeling
• Gather and analyze data for potential business expansion
• Analyze process issues and bottlenecks and recommend improvement areas
• Create reports, dashboards, and visualizations to understand business performance
• Coordinate with different departmental teams to produce better business outcomes
• Assist with project management for selected projects
• Write clear and well-structured business requirements/documents
• Identify and drive automation opportunities
• Communicate and validate requirements with relevant stakeholders
• Develop and maintain reporting tools

Requirements / Qualification

• End to End exposure in the US Healthcare Revenue Management cycle
• Hands on experience in reporting & analytics
• Good communication & Interpersonal skills
• Strong in analytical and problem-solving skills
• Proficiency in MS Office applications
• Exposure to Power BI, Power Automate, Tableau or similar applications preferred

Job Description

• Contact insurance carriers to verify patient’s insurance eligibility, benefits, and requirements.
• Contacting PCP office for Fax confirmation.
• Review chart documentation to ensure patient meets medical policy guidelines.
• Prioritize incoming authorization requests according to urgency
•  Confirm accuracy of CPT and ICD-10 diagnoses in the procedure order
• Obtain authorization via payer website or by phone and follow up regularly on pending cases
•  Request, track and obtain pre-authorization from insurance carriers within time allotted for medical and services, follow up and secure prior authorizations prior to services being performed.
• Maintain individual payer files to include up to date requirements needed to successfully obtain authorizations
• Respond to clinic questions regarding payer medical policy guidelines
• Communicate any insurance changes or trends among team.
• Maintains a level of productivity suitable for the department.
• Clearly document all communications and contacts with Insurance and personnel in standardized documentation requirements, including proper format.
• Other duties as assigned.
• Experience of Prior Auth in Dermatology specialty could be added advantage.

Requirements / Qualification

• Minimum 1 year experience in Prior Authorization
• Experience in Voice process is mandatory

Job Description

• Should have prior experience working at client facing role.
• Excellent Communication Skills, Witty, Should know how to build client rapport and manage client calls effectively.
•  RCM experience, End to End RCM experience would be added advantage.
• Team player, open to feedback, flexible to work.
• Result oriented, innovative thinker, creative, Automation knowledge would be added advantage.
• Ensuring Client SLA’s/TAT is met across the board. Focussing on giving value add to the clients.
• Understands operations & strategies. Works hand in hand with Operations.
• Knows reporting, analytics , Client decks, Client reports etc.
•  Hands on client transitions and understands the detailing involved in the transitions, SOP creation. DOU creation etc.
• Knows how to tackle client and operational issues and provides solution.

Requirements / Qualification

•  Experience in handling AR Follow-up and Denial Management.
•  Experience as TL for at least 1 year.
• Strong analytical background.
• Strong knowledge of Health care vertical in RCM.
• Excellent interpersonal and communication skills.
• Proficient in all Microsoft applications.