Business Analyst

Hello Candidates !!

Greetings from Talent Sketchers

Kindly find the details below

• Designation - Business Analyst
• Experience - 7+ years
• Location - Pune, Chennai, Mumbai, Bengaluru, Hyderabad, Kochi, Thiruvanthaapuram
• Work Mode - Hybrid

Detailed JD

We are seeking a highly skilled and detail-oriented BA with specialist RCM knowledge to help in detailing requirements for end-to-end revenue cycle operations. The ideal candidate will have hands-on experience across front-end, mid-cycle, and back-end RCM processes, with a strong understanding of payer requirements, coding standards, and claims workflows. Here is some more details 

Key Responsibilities: The candidate should be experienced in the areas shown below and have experienced in creating detailed requirements.

Front-End RCM

• Patient registration and intake with accuracy
• Insurance eligibility and benefits verification
• Prior authorization processes and coverage validation
• Documentation of medical necessity and payer requirements

Mid-Cycle RCM

• CPT, ICD-10, HCPCS, J-Codes, and SNOMED
• Specifics for submission of 837P and 837I
• Understand payer-specific rules and clean claim submission
• Denials and resubmissions with appropriate documentation

Back-End RCM

• Posting payments and Reconciliation of claims using ERA and EOBs
• Analysis of payment variances and resolution of discrepancies
• Management of patient balances and coordination of billing follow-ups
• Resolution process with finance and customer service teams

NOTE - Candidates can share their resume - shruti.a@talentsketchers.com