Senior Process Executive

Required Experience

1-3 years

Domain Knowledge

US Healthcare (RCM Voice/AR Calling process)

Employment Type

Full-time/Permanent

Location

Hyderabad

Shift Type/Timings

Night Shift-US Healthcare Shifts

Industry Type

BPO/RCM

Role Category

Operations

Role Overview

The Senior Process Executive Voice will be responsible for performing accounts receivable (AR) follow-up and denial resolution through effective communication with US insurance companies and payers. The role requires strong communication, analytical ability, and RCM knowledge to resolve claim issues, reduce outstanding AR, and improve cash flow. The senior executive will also support mentoring of junior associates and contribute to process improvements.

EssentialDuties and Responsibilities:

• Perform end-to-end AR follow-up with insurance companies via outbound calls to resolve pending/unpaid claims.
• Analyse claims to identify reasons for rejections/denials and ensure timely resolution.
• Initiate appeals or escalate unresolved claims to the appropriate department.
• Document all call outcomes and actions taken in the billing system with accuracy.
• Achieve and exceed SLA/KPI metrics such as productivity, call quality, resolution rate, and turnaround time.
• Handle complex claim escalations and ensure effective closure.
• Collaborate with Data, Quality, and Client Teams to ensure smooth claim resolution.
• Mentor new associates, share feedback, and support knowledge transfer sessions.
• Ensure strict adherence to HIPAA compliance and data confidentiality guidelines.

Required Skills

• Strong knowledge of US Healthcare RCM, especially AR follow-up, denial management, and payer guidelines.
• Excellent verbal communication skills with neutral accent and active listening.
• Ability to handle difficult conversations and negotiate effectively with payers.
• Proficiency in working with practice management systems, payer portals, and MS Office tools.
• Strong problem-solving and analytical ability.
• Attention to detail and ability to multitask while working with multiple systems.
• Flexibility to work in night shifts/US time zones.
• Team player with the ability to mentor and support junior staff.
• Ability to work 5 days a week in Hyderabad office

Qualification

• Graduate in any stream (BA/BCOM preferred).
• 1–3 years of experience in US Healthcare RCM Voice process (AR calling/Denial management).
• Prior experience in handling complex AR scenarios, Authorization process and escalations is preferred.