Operations Analyst / Senior Operations Analyst

About This Role

This role involves efficiently managing accounts receivable (AR) follow-ups, analyzing reports, and ensuring compliance with healthcare industry standards. The position suits an analyst with experience in revenue cycle management and a passion for customer service, working within a hybrid arrangement that may require full on-site presence.

Responsibilities

• Carry out AR follow-up efficiently according to daily production targets
• Generate 30+ AR reports, analyze, and prioritize work
• Download and verify correspondences related to collection function from Box folder/SFTP
• Ensure daily AR follow-ups are carried out as specified
• Ensure proper analysis is done before reaching out to insurance representatives and resolve identified internal gaps
• Develop AR and Root Cause analysis and share with management for review
• Ensure 30+ paid rate is achieved as expected for assigned clients
• Act as the point of contact for assigned clients for internal and external queries
• Ensure QA reports are reviewed, fixed, and responded back to the QA teams within 24 hours
• Enforce company regulatory standards to ensure the area of responsibility is in compliance with HIPAA and ISO standards
• Ensure all internal emails are responded to within the shift time
• Share daily and weekly assigned reports within the given timeframe
• Ensure SOPs are updated in a timely manner and according to the required level
• Conduct random QA on a percentage decided by the management
• Perform QA daily if allocated and ensure to share QA reports with the relevant personnel
• Maintain AR follow-up and call quality at 98% accuracy or higher
• Conduct training for newcomers on job-specific tasks
• Ensure the CDM tool is being used optimally, check on the system (CDM) and work on allocated/assigned claim denials, particularly those above 60+ bucket and other applicable categories
• Identify system inefficiencies and escalate issues as needed to ensure proper tool functionality
• Continuously evaluate the effectiveness of current AR inventory workflows in CDM and implement process improvements to enhance efficiency and maximize revenue inflow
• Understand information security principles and best practices (ISMS)
• Possess knowledge of recovery strategies and techniques, and identify critical process, sub-process functions and their dependencies (BCMS)
• Understand privacy principles and regulations (e.g., HIPAA) (PIMS)

Requirements

• Completed or currently pursuing a Bachelor's degree or academic/professional qualification in Finance, Healthcare, Business, or a related field