Domain Expert Ar Operations Job in 4d Global

Domain Expert AR Operations

Location: Chennai
Department: AR Operations
Career Band: Professional II

Role Overview: RCM & Denial Management

We are seeking a Domain Expert to join our AR Operations team. You will act as a bridge between physicians and U.S. insurance providers, focusing on Revenue Cycle Management (RCM). Your core mission is to review Explanation of Benefits (EOBs), identify claim denials, and drive resolutions to ensure timely and accurate payment collection.

Technical Skills & Core Competencies

Claims & Denial Expertise:

• AR Calling: Minimum 1 year of experience in U.S. Insurance follow-ups and professional verbal communication.
• Denial Management: Deep knowledge of Denials, Appeals, and Referrals processes.
• Financial Oversight: Understanding of Recoupment issues and ensuring proper payment allocation.
• EOB Analysis: Proficiency in interpreting complex Explanation of Benefits to identify billing discrepancies.

Process & Compliance:

• RCM Mastery: Thorough understanding of the end-to-end Revenue Cycle Management workflow.
• Regulatory Adherence: Strict maintenance of HIPAA compliance and patient data confidentiality during all interactions.
• Professionalism: Ability to maintain high standards of written and verbal communication with international insurance representatives.

Key Responsibilities

Operational Execution:

• Insurance Liaison: Execute calls to U.S. insurance companies to resolve outstanding billing issues and claim status.
• Strategic Resolution: Take decisive action on denied claims, including drafting Appeals and managing Referrals.
• Billing Accuracy: Identify and rectify billing errors to prevent recoupment and maximize collection efficiency.

Team & Reporting:

• Workflow Efficiency: Work independently and efficiently under the guidance of the Team Leader AR Operations.
• Documentation: Ensure all actions taken on claims are accurately documented within the RCM system.

Minimum Requirements

• Bachelor s degree or equivalent professional experience.
• 1+ year of experience specifically in AR Calling within the healthcare sector.
• Fluent command of the English language (spoken and written).
• Proven ability to work in a fast-paced environment while meeting quality and compliance benchmarks.