01Overview
You get the inventory that has already defeated someone. Aged over 120, denied twice, underpaid against contract, or stuck in a payer process nobody on the floor understands yet. Your job is to figure out the actual blocker and clear it, then write down how you did it so it stops being hard. You also carry the floor: you are the person a caller turns to when a payer rep gives an answer that does not make sense.
What you will own: The hard inventory; Appeals that win; Underpayment recovery; Escalation paths; Coaching the floor; Root cause reporting
What we look for: MANDATORY: working command of RCM metrics, net collection rate, days in AR, AR over 90, denial rate, first-pass resolution rate, clean claim rate and cost to collect; Three or more years of US healthcare AR calling, with demonstrated success on aged and denied inventory; Strong command of the appeals process: levels, deadlines, evidence requirements and reconsideration versus formal appeal; Able to read a contract or fee schedule and identify an underpayment; Excellent spoken and written English, able to escalate to a payer supervisor and to write an appeal that holds up; Willing to work the night shift on-site in Chennai, and to coach juniors while carrying your own book .
