Managed Services-BOS-RCMS- Associate - Hyderabad, India - PwC

Description

Description

& SummaryA career in our Managed Services team will provide you an opportunity to collaborate with a wide array of teams to help our clients implement and operate new capabilities, achieve operational efficiencies, and harness the power of technology.

Our Virtual Business Office team will provide you with the opportunity to act as an extension of our healthcare clients' business office. We specialize in revenue cycle functions and remediating aged 3rd party accounts receivable for hospitals, medical groups, and other providers. We leverage our custom and automated workflow and quality assurance products to enable our clients to achieve better results, which ultimately allow them to provide better patient care.

To really stand out and make us fit for the future in a constantly changing world, each and every one of us at PwC needs to be a purpose-led and values-driven leader at every level. To help us achieve this we have the PwC Professional; our global leadership development framework. It gives us a single set of expectations across our lines, geographies and career paths, and provides transparency on the skills we need as individuals to be successful and progress in our careers, now and in the future.

As an Associate, you'll work as part of a team of problem solvers, helping to solve complex business issues from strategy to execution. PwC Professional skills and responsibilities for this management level include but are not limited to:

• Invite and provide evidence-based feedback in a timely and constructive manner.

• Share and collaborate effectively with others.

• Work with existing processes/systems whilst making constructive suggestions for improvements.

• Validate data and analysis for accuracy and relevance.

• Follow risk management and compliance procedures.

• Keep up-to-date with technical developments for business area.

• Communicate confidently in a clear, concise and articulate manner - verbally and in written form.

• Seek opportunities to learn about other cultures and other parts of the business across the Network of PwC firms.

• Uphold the firm's code of ethics and business conduct

Accounts Receivable Management:

Oversee the accounts receivable process, including insurance and patient follow-up, to minimize outstanding balances. Monitor and analyze aging reports to prioritize and address delinquent accounts promptly. Implement strategies to improve collections and reduce accounts receivable days.

Insurance and Payer Relations:

Lead efforts in resolving complex insurance claim issues, including claim denials and underpayments. Establish and maintain relationships with insurance company representatives to facilitate prompt payment and claims processing. Stay updated on insurance policies, reimbursement regulations, and industry trends affecting revenue cycle operations.

Patient Communication and Customer Service:

Assist with escalated patient inquiries and complaints related to billing and insurance matters. Educate patients on insurance benefits, coverage details, and financial responsibilities. Collaborate with patient advocacy groups and financial counselors to ensure compassionate and effective patient interactions.

Process Improvement and Training:

Identify opportunities for process improvements within the revenue cycle management workflow. Develop training materials and conduct sessions to enhance the skills and knowledge of AR team members. Implement best practices to streamline AR operations and maximize efficiency.

Reporting and Analysis:

Generate and present regular reports on accounts receivable performance metrics, trends, and outcomes. Utilize data analytics to identify root causes of revenue cycle issues and implement corrective actions.

Compliance and Regulatory Adherence:

Ensure compliance with HIPAA regulations, billing guidelines, and healthcare industry standards. Collaborate with compliance officers to implement and maintain effective internal controls.

Requirements:

Bachelor's degree Finance, or related field preferred.

2-4 years of progressive experience in healthcare revenue cycle management, with a focus on accounts receivable and claims resolution.

Strong knowledge of medical billing processes, insurance reimbursement methodologies, and revenue cycle operations.

Experience with healthcare billing software (e.g., Epic, Cerner, Meditech) and proficiency in Microsoft Office applications.

Excellent leadership, communication, and interpersonal skills with the ability to mentor and motivate team members.

Analytical mindset with the ability to interpret financial data, identify trends, and make data-driven decisions.

Proven track record of achieving AR performance targets and improving revenue cycle efficiency.

Experience Level : 2 to 4 years

Shift timings: Flexible to work in night shifts (US Time zone)

Education

Degrees/Field of Study required:Degrees/Field of Study preferred:

Certifications

Required Skills

Optional Skills

Desired Languages

Travel Requirements

Not Specified

Available for Work Visa Sponsorship?

No

Government Clearance Required?

No

Job Posting End Date