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HealthRecon Connect provides technology-enabled Revenue Cycle Management solutions to US healthcare providers. The company leverages over 30 years of deep domain expertise, machine learning, AI, cutting-edge analytics, and automated workflows that help improve cash flow, patient outcomes and enable peace of mind for their clients. At HealthRecon Connect, day after day, we not only hold ourselves accountable for setting and maintaining high standards, but we also passionately strive for the highest achievement, customer delight and thrive on the challenge of high expectations and commitment to excel.

HealthRecon was certified a Great Workplace by Great Place to Work® Sri Lanka since 2018 and was adjudged one of the 40 Best Workplaces in Sri Lanka by Great Place to Work® Sri Lanka in 2021. We are also a Signatory Participant of the United Nations Global Compact.

We are looking for Senior Operations Analyst / Specialist – Credentialing to join our team. Please review the criteria and other information listed below thoroughly prior to applying and pay specific attention to the work week, shift details and other features of the job. Due to the large volume of applications we receive, all applications will be reviewed in the order in which they were received and only the candidates short-listed for the first round of interviews will be contacted. Thank you for your understanding.

Job Vacancy:
Senior Operations Analyst / Specialist – Credentialing

Work Week:
Monday to Friday

Shift Window:
7:30pm to 4:00am SLST (Night shift)

Other Features:
Full-time
US calendar applicable

Responsibilities:

  • Credentialing application submission & follow up to be carried out efficiently according to the daily production targets specified by management.
  • Generate credentialing reports, analyze and work based on priority levels.
  • Download/ verify correspondences related to credentialing function from Box folder/ SFTP/ EHR.
  • Ensure daily credentialing follow ups carried out as expected.
  • Ensure proper analysis being done before reaching out to insurance representatives and resolve internal gaps are identified eliminated.
  • Develop a Credentialing Plan and Root Cause analysis and share with management review.
  • Ensure payer approval rate is achieved as expected for the assigned client/s.
  • Act as the point of contact for assigned client for internal and external queries.
  • Ensure QA reports are reviewed, fixed, and responded back to the QA teams within 24 hours.
  • Ensure to responded back to all internal e-mails within the shift time.
  • Daily and Weekly assigned reports to be shared within the given timelines.
  • Ensure to update SOPs 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.
  • Credentialing payer follow up and call quality to be maintained at 98% accuracy or greater.
  • Conduct training to newcomers on the job specific functions.

 

Qualifications/Criteria:

  • Partially qualified in any degree / professional qualification.
  • 2+ years’ experience in RCM Operations and at least six month’s experience in Credentialing.
  • RCM Billing Operations knowledge will be an advantage.
  • Ability to work with MS Office package.
  • Good written and verbal communication skills.
  • Ability to work under pressure.

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