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Tag: Patient Insurance Verification

How to Improve Patient Insurance Verification Loop?

How to Improve Patient Insurance Verification Loop

Insurance verifications and authorizations are critical components of revenue cycle management in healthcare organizations. When these essential workflows lack efficiency and proper management, they inevitably create significant delays in patient care delivery and claims processing. This results in a challenging cycle that negatively impacts both healthcare providers and patients alike. Breaking free from this inefficient pattern requires implementing a strategic and proactive approach to optimize processes and eliminate common obstacles. Healthcare facilities must focus on developing comprehensive solutions that address both immediate verification challenges and long-term operational efficiency. Understanding Verification Delays and Their Effects The impact of delayed insurance verifications and prior authorizations extends across multiple crucial areas of healthcare operations, creating far-reaching consequences that affect the entire healthcare delivery system: Key Obstacles in the Process Identifying and understanding common challenges in the insurance verification process is essential for implementing effective solutions. Healthcare organizations must recognize and address these fundamental barriers to improve their verification workflows: Effective Solutions for Verification Management Healthcare facilities can enhance their revenue cycle management through these comprehensive approaches: Enhancing Operational Efficiency Strategic workflow improvements can significantly reduce processing times and enhance overall efficiency. Essential elements include: Advantages of Process Improvement Implementing efficient medical billing services and streamlined verification processes delivers multiple significant benefits: Conclusion Effectively addressing verification and authorization delays is crucial for maintaining high patient satisfaction levels, ensuring robust financial health, and achieving operational excellence in healthcare organizations. Through implementation of improved workflows, strategic management approaches, and modern technology solutions, healthcare organizations can successfully overcome these common challenges. The combination of streamlined processes, advanced technology adoption, and skilled staff management creates a foundation for sustainable operational improvement and enhanced service delivery. Organizations that prioritize verification process optimization position themselves for long-term success in an increasingly complex healthcare environment. At BIS, we specialize in providing comprehensive revenue cycle management solutions designed to optimize your healthcare operations and improve overall efficiency. Want to improve your insurance verification process and transform your revenue cycle management? Contact BIS at www.businessintegrityservices.com or call (800) 592-6079 to discover how our expert team can enhance your operational efficiency and help you achieve your organizational goals.

Call Center-Bilingual Agent

Job Description
If you are bilingual with a minimum B2 English level, who want to work in a company that offers growth opportunities, a wonderful work environment then, we are looking for you! We need you to have great attitude and empathy to receive and make calls to our clients who are in the health sector.

We offer a base salary of COP 2,550,000 per month

-Two days off (Saturday and Sunday)
-We work with the American calendar,
-8 hours daily

If you are interested, apply and spread the word to your friends and benefit from our referral plan.

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Bi-Lingual Patient Service agent

Mission of the position:

Assist as many patients as possible in completing their recommended procedures, ensure the proper authorization process, and provide information with the utmost care.

Responsibilities:

• Continuous monitoring of authorization status for processing orders
• Telephone contact with patients to address their service requests
• Responding to emails regarding the status or follow‑up of administrative procedures
• Scheduling, rescheduling, or cancelling procedures and related follow‑up appointments
• Handling incoming patient calls as needed
• Providing patients with information and assistance regarding the financial responsibilities of procedures
• Building trust with patients through empathetic communication
• Being proactive to anticipate and avoid potential future concerns
• Looking for opportunities to go above and beyond
• Performing any additional support duties requested by the immediate supervisor, as operational needs require
• Complying with instructions from supervisors regarding job‑related responsibilities

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IT Support Agent

Job Description
Are you a tech-savvy bilingual professional with strong problem-solving skills and a minimum B2 English level? We’re looking for you! As an IT Support Agent, you’ll assist clients remotely, troubleshoot system issues, and ensure timely technical resolutions. A great attitude, adaptability, and effective communication are key to this role.

We offer a base salary of COP 2,550,000 per month

  • Two days off (Saturday and Sunday)

  • We work with the American calendar

  • 8 hours daily

If you are interested, apply and spread the word to your friends and benefit from our referral plan.

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Business Analytics Agents

Job Description
Do you have an analytical mindset and a minimum B2 English level? We are hiring Business Analytics Agents to support data-driven decision-making across healthcare operations. You’ll gather, analyze, and interpret business data to provide actionable insights. Attention to detail and critical thinking are essential.

We offer a base salary of COP 2,550,000 per month

  • Two days off (Saturday and Sunday)

  • We work with the American calendar

  • 8 hours daily

If you are interested, apply and spread the word to your friends and benefit from our referral plan.

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Quality Assurance Agent

Job Description
If you have an eye for detail and a minimum B2 English level, join us as a Quality Assurance Agent! You’ll review call interactions, monitor service quality, and ensure compliance with company standards. We’re seeking professionals who are passionate about continuous improvement and customer satisfaction.

We offer a base salary of COP 2,550,000 per month

  • Two days off (Saturday and Sunday)

  • We work with the American calendar

  • 8 hours daily

If you are interested, apply and spread the word to your friends and benefit from our referral plan.

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AM - RCM Data Analyst

Job Opening: Assistant Manager – RCM Data Analyst (WFO – Night Shift)

📍 Location: Chennai, India
🕒 Experience: 5+ Years | 🌓 Shift: Night | 💼 Work Mode: Work from Office (WFO)

Are you an experienced data analyst with a strong background in healthcare RCM and a passion for transforming data into actionable insights? Join our team and help drive business intelligence in the healthcare sector.

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Business Intelligence - Associate Sr Associate

Experience – 1 to 2+ Years (Night Shift)

SKILLS REQUIRED

• Develop, maintain, and debug SSIS packages and SQL ETL solutions for data extraction,
transformation, and loading.
• Design SQL stored procedures, functions, views, and database objects to support ETL processes. Analyze complex data sets to derive business insights and support strategic initiatives.
• Conduct testing, prepare ETL deployments, and ensure data accuracy and efficiency.

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Business Intelligence - TL

Experience: 5+ Years
Skills Required:

  • Analyze data models and create Power BI reports to support US Healthcare RCM decisions.

  • Expert in Advanced Excel, Power Query, SQL, and data comparison for business analysis.

  • Communicate effectively with stakeholders for requirements gathering, verification, and delivery.

  • Lead sprints, ensure timely report delivery, and document SOPs and processes.

  • Provide insights on denials, NCR, GCR, and DSO with strong leadership and process improvement skills.

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Insurance AR Callers

Job Title: Insurance AR Caller

Location: Trichy

Work Mode: Work from Office (WFO)

Shift: Night Shift Experience

Experience: 0.6 to 2+ Years

Roles and Responsibilities:

· Perform end-to-end follow-up on insurance claims with US healthcare payers.

· Handle denied, underpaid, and pending claims by analyzing the root cause and taking corrective actions.

· Work on various insurance aging reports and maintain call logs with accurate documentation.

· Contact insurance companies to get claim status and initiate necessary actions (appeals, corrections, resubmissions).

· Understand and interpret Explanation of Benefits (EOBs) and denial codes.

· Collaborate with internal teams to resolve billing discrepancies and ensure timely claim resolution.

· Maintain productivity and quality standards as per SLA requirements.

· Stay updated on industry trends and payer-specific guidelines.


Key Skills Required:

· An ability to identify and address common denial reasons and resolve rejections efficiently.

· Good understanding of the healthcare revenue cycle, including eligibility, charge entry, billing, AR follow-up, and payment posting.

· Capable of analyzing account status, identifying resolution pathways, and working with minimal supervision.

· Strong verbal and written English communication to interact with insurance representatives and internal teams effectively.


Mandatory Skills:

· Minimum of 1 year of experience in US healthcare Insurance AR calling.

· Familiarity with payer policies, denial codes, and claim resolution workflows.

· Proficiency in working with RCM software and tools.

· Attention to detail and ability to work in a fast-paced environment.


Eligibility Criteria:

· Graduate in any discipline.

· Must be willing to work night shifts from the office in Trichy.

· Prior experience in AR Calling is preferred.

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Quality Analyst – Authorization (QA – Auth) - Trichy

Experience – 4+ Years – Trichy Night Shift


SKILLS REQUIRED

• Conduct quality audits on prior authorization processes to ensure compliance with payer and organizational standards.
• Analyze audit findings to identify trends, inefficiencies, and areas for improvement.
• Use Excel to generate reports, track KPIs, and support proactive quality initiatives.
• Collaborate with teams to implement corrective actions and stay informed on evolving payer and regulatory requirements.

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Specialist - RCM Data Analyst

Job Title: Specialist – RCM Data Analyst (WFO)

📍 Location: Chennai, Tamil Nadu
🕒 Experience: 3+ Years
🌙 Shift: Night Shift
💼 Work Mode: Work From Office

🔍 Role Summary

We are looking for an experienced RCM Data Analyst to join our dynamic team in Chennai. This role is perfect for individuals with a strong background in data analytics and healthcare revenue cycle management, who can provide actionable insights and improve operational outcomes.

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QA – Assistant Manager / Manager

📍 Location: Chennai, Tamil Nadu
🕒 Experience: 5+ Years
🌙 Shift: Night Shift
💼 Work Mode: Work From Office

🔍 Role Summary
We are seeking a Quality Assurance professional with proven leadership experience to join our healthcare operations team. The ideal candidate will be responsible for ensuring high standards of process compliance, managing audit teams, and driving continuous quality improvement across revenue cycle functions.

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Senior Specialist – Business Intelligence (BI)

Experience – 4+ Years – Chennai Night Shift


SKILLS REQUIRED
• Develop and maintain SSIS packages and SQL
•
procedures for efficient ETL processes.
Analyze large datasets to support business insights and strategic decisions.
• Design and manage database objects, security, and data integration workflows.
• Test, debug, and deploy ETL solutions across environments.
• Demonstrate strong analytical, problem-solving, and project management skills.

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Senior UiPath Developer

Position: Senior UiPath Developer (On-site, Chennai)

Experience: 5+ years in end-to-end UiPath automation projects

  • Proficient in RE Framework and UiPath Computer Vision Activities
  • Must handle full lifecycle: requirement gathering to deployment
  • Able to create detailed documentation (PDD, SDD, etc.)
  • Strong in logical thinking and complex business rule implementation
  • No POC experience – must have real project exposure with Computer Vision
  • Collaborate with stakeholders to deliver scalable automation solutions
  • Excellent troubleshooting, optimization, and communication skills
  • Healthcare domain experience is a plus but not mandatory
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Business Intelligence Analyst

Position: Business Intelligence Analyst (Full-Time, Chennai)

  • Develop and manage ETL processes using SSIS and SQL Server
  • Analyze complex data sets to drive business insights
  • Create and maintain stored procedures, views, and functions
  • Design and implement data warehouse solutions
  • Work with SSRS, SSAS, and data visualization tools like Power BI/Tableau
  • Experience with cloud ETL tools (Azure Data Factory/AWS Glue) is a plus
  • Strong analytical, problem-solving, and communication skills required
  • Familiarity with Agile/Scrum methodologies preferred
  • Qualification: Bachelor’s in IT/Computer Science
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Team Lead – Credit Balance - Trichy

🔹 Position: Team Lead – Credit Balance (WFO)
📍 Location: Trichy
🕒 Shift: Night Shift
🧑‍💼 Experience: 3 to 5+ Years

Skills Required:

  • Manage and resolve credit balance discrepancies across customer accounts with accuracy.

  • Collaborate with cross-functional teams to ensure timely issue resolution and process adherence.

  • Maintain records, generate reports, and analyze trends related to credit balances.

  • Support process improvements and assist in mentoring junior team members.

  • Prefer experience in US healthcare RCM, financial compliance, and credit balance systems.

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Quality Analyst – Insurance AR - Trichy

Position: Quality Analyst – Insurance AR
Location: Trichy
Experience: 2 to 4+ Years

Skills Required:

  • Review and audit AR process transactions for accuracy, adherence, and compliance.
  • Evaluate performance of AR callers handling insurance claims and denials.
  • Identify quality issues, provide actionable feedback, and support training needs.
  • Maintain audit reports and communicate error trends to the operations team.
  • Collaborate with the QA team to refine quality frameworks and benchmarks.
  • Ensure timely reporting of quality metrics to internal stakeholders.
  • Work closely with team leads to drive continuous performance improvement.
  • Strong understanding of US Healthcare RCM and Insurance AR processes.
  • Experience with QA tools, audit templates, and performance scorecards.
  • Excellent analytical, documentation, and communication skills.
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Specialist / Senior Specialist SCM - Strategic Sourcing

Position: Strategic Sourcing Manager – Healthcare (WFO)
Location: Chennai
Shift: Night Shift
Experience: 5 to 7+ Years

Skills Required:

  • Develop and execute strategic sourcing strategies for surgical and operating room categories.
  • Lead RFP processes, vendor negotiations, and contract finalization.
  • Collaborate with internal teams to understand needs and align sourcing initiatives.
  • Build and maintain strong relationships with suppliers for improved service delivery.
  • Draft contracts with clear business requirements, KPIs, and risk mitigation measures.
  • Monitor supplier performance and resolve contract-related issues effectively.
  • Maintain knowledge of industry trends and category-specific developments.
  • Drive sourcing efficiency and cost optimization across projects.
  • Prefer experience in healthcare sourcing and contract negotiations.
  • Strong project management and stakeholder communication skills.
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Senior Associate / Specialist - Power App Developer

Position: Power App Developer – Revenue Cycle Management
Location: Chennai
Experience: 2 to 4 Years

Skills Required:

  • Design and develop canvas and model-driven Power Apps tailored to RCM workflows.
  • Automate processes using Power Automate, Dataverse, and Microsoft 365 tools.
  • Support client onboarding, including configuration and data migration activities.
  • Act as a Business Analyst to gather, interpret, and implement client requirements.
  • Collaborate with cross-functional teams to ensure scalable and maintainable solutions.
  • Maintain and enhance existing Power Apps and workflows with a focus on performance.
  • Ensure data integrity, security, and compliance with healthcare standards.
  • Prefer experience in US Healthcare RCM or SaaS implementation projects.
  • Familiarity with JIRA, Azure Groups, and security roles in Dynamics 365 is a plus.
  • Strong English communication skills (written and verbal) are essential.
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Specialist / Senior Specialist – Automation – Chennai

Position: Specialist / Senior Specialist – Automation
Location: Chennai
Experience: 2 to 4 Years

Skills Required:

  • Lead end-to-end automation projects — from requirement gathering to deployment — with minimal supervision.
  • Design, develop, and maintain automation workflows using RPA tools (preferably UiPath) and industry best practices.
  • Apply UiPath RE Framework for scalable and reusable automation solutions.
  • Utilize Computer Vision activities for advanced automation scenarios.
  • Create and maintain PDD, SDD, and related project documentation.
  • Collaborate with stakeholders to translate business needs into efficient automation solutions.
  • Troubleshoot, optimize, and maintain existing automations for performance and reliability.
  • Ensure automation solutions meet governance, compliance, and security standards.
  • Stay updated on the latest RPA trends, tools, and emerging technologies.
  • Manage multiple automation initiatives, ensuring timely delivery and high-quality outcomes.
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Insurance AR Analyst

Position: Quality Analyst – Insurance AR
Location: Trichy (Day Shift)
Experience: 0.6 to 2+ Years

Skills Required:

  • Perform end-to-end follow-up on insurance claims with US healthcare payers to ensure timely resolution.
  • Review and analyze denied, underpaid, and pending claims to identify root causes and take corrective actions.
  • Contact insurance companies to obtain claim status and initiate actions such as appeals, corrections, and resubmissions.
  • Interpret and work with Explanation of Benefits (EOBs) and denial codes for accurate claim handling.
  • Prepare and manage insurance aging reports, maintaining detailed and accurate call logs.
  • Collaborate with internal teams to resolve billing discrepancies and ensure claims are processed within SLA timelines.
  • Stay updated with payer-specific guidelines, industry changes, and compliance requirements.
  • Maintain productivity, quality standards, and accuracy while meeting performance targets.
  • Utilize RCM software and tools effectively for claim tracking, documentation, and resolution.
  • Demonstrate strong verbal and written communication skills for effective interaction with payers and internal stakeholders.
View & Apply

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Trainee - Authorization

Job Title: Trainee – Authorization

Location: Trichy

Work Mode: Work from Office (WFO)

Shift Timing: Day Shift (08.00 AM – 05.30 PM IST)


Role and Responsibilities:

· Communicate effectively (verbal & written) to interact with team members and external partners.

· Assist in initiating and following up on authorization requests to ensure timely approvals.

· Learn and work within RCM processes, ensuring accurate data entry and resolution of authorization issues.

· Maintain accurate documentation and provide regular updates on the status of requests.

· Work collaboratively with the team to meet deadlines and deliver quality results.

· Display a keen eye for detail and accuracy in every task.

· Willingness to work in flexi shifts as required.


Skills Required:

· Strong communication skills, both verbal and written.

· Ability to learn quickly and adapt to new concepts.

· Detail-oriented and capable of handling tasks with precision.

· Ability to work well in a team environment.


Eligibility Criteria:

· Freshers are welcome to apply.

· A basic understanding of RCM processes is a plus but not required.

· Excellent verbal and written communication skills.


Educational Qualification:

· Graduation in any discipline

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Associate / Senior Associate - AI Developer

Job Title: Executive – AI Developer (Voice AI – 1 Year Experience)
Location: Chennai, India
Experience: 1+ Years
Employment Type: Full-Time (Work From Office)

Skills Required:

  • Develop and implement AI voice agents for automated inbound and outbound voice calls
    using BlandAI.
  • Customize AI models for specific business use cases, especially customer service and lead
    engagement.
  •  Train and fine-tune language models for improved voice response accuracy with high level of
    US based communication.
  •  Collaborate with cross-functional teams in the business units to define voice interaction
    flows.
  •  Integrate voice AI with CRM and other communication platforms.
  •  Monitor, evaluate and optimize model performance regularly.
  •  Troubleshoot and resolve any technical issues related to AI voice operations.
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Team lead - Automation

Job Title: Senior UiPath Developer
Location: Chennai, India
Experience: 7+ Years
Employment Type: Full-Time (Work From Office)

Job Summary:
We are looking for an experienced UiPath Developer to lead end-to-end automation projects. The role involves designing, developing, and deploying automation solutions using UiPath RE Framework, Orchestrator, and Computer Vision, while managing a small team and ensuring delivery excellence.

Key Responsibilities:

  • Lead and execute complete automation lifecycle — design, development, testing, and deployment.

  • Develop reusable workflows using UiPath best practices.

  • Implement and optimize UiPath Computer Vision automations.

  • Collaborate with business teams to translate requirements into automation solutions.

  • Perform manual/automated testing and manage bots via Orchestrator.

  • Document processes (PDDs, SDDs) and mentor junior developers.

Skills Required:

  • 7+ years in UiPath automation with strong RE Framework experience.

  • Hands-on with Orchestrator and Computer Vision (live project experience).

  • Strong analytical, problem-solving, and communication skills.

  • Minimum 1 year of team management experience.

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Associate / Senior Associate - Branding - Graphic Designer | Content Writer

Location: Trichy

Work Mode: WFO

Shift: Day/Mid Shift

Experience: 1-2+ Years

Skills Required:

  • Assist in creating and executing brand communication and creative strategies.
  • Create and manage written content for social media, campaigns, and other digital platforms.
  • Support graphic design needs (e.g., banners, templates, social media creatives).
  • Manage social media accounts and plan platform-specific content calendars.
  • Conduct market research and competitor analysis to align brand positioning.
  • Collaborate with marketing, design, and content teams to maintain brand consistency.

 

Eligibility Criteria:

  • Strong communication, storytelling, and presentation skills.
  • Proficient in graphic design tools (e.g., Canva, Photoshop, Illustrator).
  • Excellent content writing skills with attention to tone and messaging.
  • Knowledge of social media management and audience engagement strategies.
  • Basic knowledge of video editing or motion graphics (e.g., Premiere Pro, After Effects, CapCut).
  • Familiarity with digital marketing fundamentals (e.g., SEO, paid campaigns, analytics).
  • Adaptable, creative, and willing to travel temporarily for work assignment
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PAT Nurse

Location: Colombia
Work Mode: Work from Office
Shift: Day Shift

Position: PAT Nurse

Key Responsibilities:

  • Certified Nurse

  • Make calls to patients scheduled for surgical procedures

  • Complete the PAT Form

  • Ensure accuracy and confidentiality in patient data

  • Communicate effectively with patients and medical staff

Requirements:

  • English Level: B2+

  • Strong communication and documentation skills

  • Attention to detail

  • Relevant nursing certification

Base Salary: $2,850,000 COP

📧 Send your CV to: carolina.a@thebisteam.com

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Associate / Senior Associate – Human Resources Talent Engagement

Location: Trichy

Work Mode: Work From Office (WFO)

Shift: Night Shift

Job Summary:

We are seeking a passionate and detail-oriented Human Resource Talent Engagement Specialist to join

our HR team. The ideal candidate will support a wide range of HR functions including employee

engagement, relations, performance management, and policy implementation. This role offers an

exciting opportunity to contribute to a growing organization’s people strategy while ensuring a positive

and engaging work culture.

Key Responsibilities:

  • Support HR Business Partners in implementing HR initiatives that align with organizational

goals and business objectives.

  • Assist in talent acquisition, onboarding, and workforce planning to ensure an efficient and

engaging employee experience.

  • Drive and coordinate employee engagement, employee relations, and performance

management activities to enhance workplace morale and productivity.

  • Handle employee queries, support conflict resolution, and assist in grievance management

with professionalism and empathy.

  • Ensure HR policy implementation and compliance with company guidelines and applicable

labour laws.

  • Collaborate with department heads to identify and address training and development needs.
  • Maintain accurate HR documentation, reports, and analytics to support data-driven decisions.
  • Support HR process improvements and contribute to employee retention strategies.
  • Demonstrate strong communication, interpersonal, and problem-solving skills in managing

employee interactions and HR initiatives.

  • Utilize HRMS tools and MS Office applications effectively for daily HR operations.
  • Work collaboratively in a dynamic, fast-paced environment with a proactive and solution[1]oriented mindset.
  • Exposure to the healthcare industry is preferred, though not mandatory.

 

Qualifications:

  • Bachelor’s or master’s degree in human resources,or a related field.
  • Prior experience in HR functions such as Talent Engagement, Employee Relations, or HR

Operations will be an added advantage.

  • Strong interest and commitment to building expertise in Employee Engagement, Performance

Management, and HR Operations

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GM / Associate Director – Insurance AR (Hospital Billing)

Job Title: Associate Director – Insurance AR (Hospital Billing)

Department: Insurance AR

Location: Trichy

Reports To: VP – Operations

Job Summary:

The Associate Director – Insurance AR will be responsible for leading and managing the hospital billing Insurance and Patient AR operations across inpatient, outpatient, and emergency services. The role involves overseeing end-to-end revenue cycle activities, ensuring billing accuracy, compliance, process efficiency and timely collections to optimize financial performance. The position requires strong analytical, operational and leadership capabilities to drive process improvement and ensure adherence to quality and compliance standards.

Key Responsibilities:

  1. Billing Operations Management
    • Oversee and manage the end-to-end hospital billing process primarily focused on Insurance and Patient AR, including charge capture, claim submission, coding denial review and payment 
    • Ensure accuracy and timeliness of billing for inpatient, outpatient and ancillary services.
    • Monitor daily billing volumes, rejections and backlogsto maintain operational efficiency.
  1. Team Leadership & Performance Management
    • Lead a large team of billing executives, leads, and managers across different shifts or units.
    • Set clear performance goals, conduct periodic reviews, and drive accountability.
    • Provide training and mentoring to enhance team performance and domain knowledge.
  1. Compliance & Quality Control
    • Ensure adherence to payer policies, audit requirements, and hospital billing guidelines.
    • Conduct internal audits to minimize denials, rework and compliance risks.
    • Collaborate with coding, AR, and denial management teamsfor seamless processflow.
  1. Revenue Optimization & Reporting
    • Track key RCM metricssuch as DSO (Days Sales Outstanding), billing accuracy, and clean claim rate.
    • Analyze billing trends, root causes for rejections, and recommend process improvements.
    • Prepare and present periodic performance dashboards and MIS reports to senior
  1. Stakeholder Collaboration
    • Partner with medical, finance, IT, and insurance departmentsto resolve billing-related issues.
    • Liaise with clients, payers, and auditorsfor escalations, reconciliations, and clarifications.
    • Support implementation of new billing systems or process automation initiatives
  1. ProcessImprovement & Strategy
    • Identify areasfor automation and processstandardization to improve TAT and accuracy.
    • Supportstrategic planning forscaling billing operations and workforce optimization.
    • Contribute to policy formation, SOP documentation, and quality assurance frameworks.

Key Skills & Competencies:

  • Strong understanding of hospital billing insurance AR, charge capture and RCM workflows.
  • Expertise in CPT/ICD coding, DRG codes, payer policies and denial management.
  • Proficiency in hospital billing software (EPIC, Allscripts, NextGen, HST, Intergy, HIS, Meditech,
  • Cerner, Athena, or similar).
  • Analytical mindset with ability to interpret financial and operational data.
  • Excellent leadership, communication, and stakeholder management skills.
  • Ability to drive process excellence and lead large cross-functional teams.

Qualifications & Experience:

  • Bachelor’s or master’s degree, Healthcare Administration, or related field.
  • 10–15 years of experience in hospital billing or healthcare RCM, with at least 5 – 7 years’
  • experience in a managerial/leadership role.
  • Detailed work experience in hospital billing mandatory.
  • Strong knowledge of healthcare compliance standards and audit requirements
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Insurance Authorization - QA

Job Title: Quality Analyst – Authorization
Location: Trichy
Work Mode: Work from Office (WFO)
Shift: Night Shift
Experience Required: 4+ Years

Job Description:

Roles and Responsibilities:

  • Perform quality audits on prior authorization workflows, including verification, request initiation, and follow-up activities.
  • Ensure all authorization requests meet payer-specific and organizational quality standards.
  • Analyze audit results to identify recurring issues, inefficiencies, or process deviations.
  • Maintain comprehensive and accurate quality reports and provide data-backed insights to management.
  • Lead or participate in quality meetings with team members to discuss audit findings and improvement plans.
  • Utilize MS Excel to prepare reports, track KPIs, and perform trend analysis for proactive quality management.
  • Support the implementation of corrective actions and quality improvement projects based on audit outcomes.
  • Stay updated with payer requirements, prior authorization trends, and regulatory updates.

Mandatory Skills:

  • In-depth knowledge of the Authorization process within the healthcare RCM environment.
  • Experience in performing audits of authorization-related transactions and workflows.
  • Ability to conduct meetings and communicate findings effectively to internal teams.
  • Proficiency in report creation, tracking, and maintenance.
  • Intermediate to advanced skills in MS Excel for data management and visualization.
  • Strong ability to conduct trend analysis and derive actionable insights from data.

Eligibility Criteria:

  • 4+ years of experience in Authorization within the healthcare RCM industry.
  • Prior QA or auditing experience is highly desirable.
  • Strong communication skills and attention to detail.
  • An analytical mindset with a commitment to maintaining high-quality standards.

Educational Qualification:

  • Graduate in any discipline.
View & Apply

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Senior Associate / Specialist - AI Developer

Job Title: Senior Associate – AI Developer (Voice AI & Agentic AI)
Location: Chennai, India
Experience: 3+ Years
Employment Type: Full-Time (Work from Office)

Job Summary:

We are seeking a proactive and technically skilled AI Developer with a strong foundation in Prompt Engineering, Python, and API integrations, along with exposure to Agentic AI systems. The ideal candidate will have at least 1 year of hands-on experience in voice-based AI solution development, and a passion for building intelligent, autonomous systems that enhance business communications through inbound and outbound voice automation. You will play a critical role in implementing real-world Agentic AI capabilities and integrating them with CRMs and communication platforms using tools like BlandAI or similar.

Key Responsibilities:

  • Design and develop AI-powered voice agents for automated inbound and outbound calls using BlandAI or equivalent tools.
  • Apply Agentic AI principles to enable autonomous decision-making and task execution in business workflows.
  • Engineer and fine-tune prompt for LLMs to drive accurate and context-aware voice responses.
  • Customize language models for domain-specific use cases (e.g., customer service, lead generation).
  • Collaborate with internal teams to define and implement voice interaction flows and workflows.
  • Build and maintain Python-based AI pipelines, integrating with third-party APIs and services.
  • Integrate AI solutions with CRMs (e.g., Microsoft Dynamics) and communication platforms.
  • Monitor model performance, handle fine-tuning, and ensure high voice recognition accuracy, especially for US-based users.
  • Use workflow automation tools like n8n (or similar) for efficient orchestration of business logic.
  • Diagnoses and troubleshoot issues related to AI agents, APIs, or voice platforms.

 

Required Skills & Qualifications:

  • Bachelor’s degree in computer science, Artificial Intelligence, Engineering, or a related field.
  • 2+ years of software development experience with a minimum of 1 year building AI/ML-based voice solutions.
  • Strong experience in Prompt Engineering, including crafting, testing, and optimizing prompts for LLMs.
  • Good understanding of Agentic AI concepts and implementation in task automation workflows.
  • Proficiency in Python and working with tools like VS Code.
  • Experience with API integrations, RESTful services, and working with third-party platforms.
  • Knowledge of NLP, ASR (Automatic Speech Recognition), and text-to-speech (TTS) systems.
  • Strong logical thinking and debugging skills, with attention to detail.
  • Good verbal and written communication skills.

 

Preferred Qualifications:

  • Experience with BlandAI, or similar voice automation platforms.
  • Familiarity with n8n or other low-code automation tools.
  • Experience integrating AI workflows with CRMs like Microsoft Dynamics.
  • Exposure to voice call analytics and performance tuning.
  • Prior work experience in domains such as healthcare or customer service is a plus.
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Insurance AR – Team Lead

Job Title: Insurance AR – Team Lead

Location: Trichy
Work Mode: Work from Office (WFO)
Shift: Night Shift
Experience: 4-5+ Years

 

Roles & Responsibilities:

  • Lead and manage a team of Insurance AR executives, ensuring adherence to SLAs, productivity, and quality benchmarks.
  • Oversee end-to-end AR activities including claims follow-up, denial management, appeals, and resolution of complex AR issues.
  • Allocate work, monitor daily performance, and provide coaching and feedback to improve team efficiency.
  • Analyze AR aging, denial trends, payment patterns, and root causes to implement corrective action plans.
  • Conduct regular team huddles, performance reviews, and training sessions to enhance skill levels.
  • Ensure timely escalation and resolution of critical accounts, denials, or payer-specific issues.
  • Maintain accurate documentation and prepare periodic AR performance reports for management.
  • Collaborate with cross-functional teams (coding, billing, payment posting) to improve AR outcomes and reduce rejections.
  • Ensure compliance with payer policies, HIPAA guidelines, and organizational process standards.

 

Skills Required:

  • Strong expertise in following up on claims, managing complex denials, and handling appeals.
  • Prior experience in leading a team, task delegation, performance monitoring, and coaching.
  • Ability to analyze aging reports, identify trends, and drive process improvements.
  • Strong verbal and written communication skills for client interaction and team coordination.

 

Eligibility Criteria:

  • 4 Years of experience in US Healthcare RCM with specialization in Insurance AR.
  • Minimum 1–2 years of experience in mentoring or leading AR associates.
  • Proficient in MS Excel and familiar with RCM tools and billing platforms.
  • Strong interpersonal skills, problem-solving ability, and decision-making capability.

 

Educational Qualification:

  • Graduation in Any Discipline.
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Associate/Senior Associate – Credentialing

Job Title: Associate/Senior Associate – Credentialing

Location: Trichy
Employment Type: Full-time
Shift: Night Shift

Job Description

We are seeking a detail-oriented Credentialing Specialist with strong experience in provider credentialing, onboarding, and primary source verification. The ideal candidate will be responsible for ensuring that all healthcare providers meet organizational, state, and federal standards while maintaining accurate and up-to-date credentialing records.

 

Roles and Responsibilities

  • Conduct comprehensive provider credentialing, including collecting, reviewing, and verifying education, training, licensure, certifications, and work history.
  • Perform thorough primary source verification (PSV) to validate provider qualifications and credentials.
  • Manage the complete provider onboarding process, ensuring timely submission of required documentation.
  • Ensure compliance with state, federal, and organizational regulations throughout the credentialing lifecycle.
  • Prepare, complete, and submit applications for provider enrollment with insurance networks, Medicare, Medicaid, and for hospital privileges.
  • Track application statuses, follow up on pending approvals, and communicate updates to stakeholders.
  • Maintain accurate and up-to-date provider profiles in credentialing databases and systems.
  • Monitor expiration dates for licenses and certifications, ensuring timely renewals.
  • Act as a liaison between providers, insurance networks, regulatory agencies, and internal departments.
  • Collaborate with physicians and healthcare staff regarding credentialing requirements and updates.
  • Identify and resolve discrepancies or delays in credentialing or enrollment processes.
  • Address provider inquiries and investigate complaints related to credentialing and enrollment.

 

Qualifications and Education Requirements

  • Minimum 1+ years of experience in provider credentialing.
  • Graduation in any discipline.

 

Preferred Skills

  • Strong exposure to provider credentialing, onboarding, and primary source verification.
  • Excellent attention to detail and strong organizational skills.
  • Experience with credentialing software and databases (e.g., CAQH, PECOS).
  • Familiarity with regulatory guidelines such as CMS, NCQA, and Joint Commission.
  • Ability to work independently, prioritize tasks, and meet deadlines.
  • Strong communication skills to collaborate effectively with clients and internal billing teams.
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Associate - Payment Posting

Job Title: Associate – Payment Posting

Location: Trichy
Work Mode: WFO
Shift: Night Shift
Experience: 1+ Year in US Healthcare Payment Posting


Roles & Responsibilities:

  • Post insurance and patient payments (EOB/ERA/EFT) accurately into the billing system.
  • Perform EFT/ERA conversion, validation, and reconciliation.
  • Handle EFT/ERA conversion with payors by submitting the required enrollment forms to insurance companies.
  • Manage payor enrollment processes, including form submission and follow-up for activation.
  • Identify and resolve payment discrepancies, underpayments, and unapplied amounts.
  • Review payer adjustments, denial codes, and remittance details.
  • Maintain accurate payment records and support month-end closing.
  • Coordinate with AR, billing, and client teams to resolve posting issues.

 

Skills Required:

  • Strong knowledge of US RCM payment posting process.
  • Ability to interpret EOB/ERA and adjustment codes.
  • Good analytical skills and attention to detail.
  • Proficiency in MS Office and familiarity with RCM software.
  • Effective communication and time-management skills.

 

Eligibility:

  • Graduate in any discipline.
  • Minimum 1 years’ experience in Payment Posting.
  • Willing to work from the office in Night shift at Trichy.
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Team Lead – AI Developer (Prompt Engineering & Agentic AI)

Job Title: Team Lead – AI Developer (Prompt Engineering & Agentic AI)Location: Chennai, India
Experience: 5–6 Years
Shift: Mid Shift (1pm -10pm)
Employment Type: Full-Time (Hybrid)

Job Summary:

We are seeking an experienced and technically strong AI Team Lead with deep expertise in Prompt Engineering, Agentic AI, Python, and API integrations. The ideal candidate will lead a team of AI developers in designing, building, and deploying intelligent AI-driven solutions, including autonomous agents and workflow-based systems. This role requires a hands-on leader who can architect scalable AI solutions while mentoring the team and driving delivery excellence.

Key Responsibilities:

  • Lead and mentor a team of AI developers, providing technical guidance and best practices.
  • Design and implement Agentic AI systems for autonomous decision-making and task execution.
  • Define and standardize advanced prompt engineering strategies for complex AI workflows.
  • Architect and oversee AI-driven solutions using LLMs, prompt chaining, and tool-based reasoning.
  • Develop and maintain Python-based AI pipelines using VS Code and modern development practices.
  • Lead and manage API integrations with third-party platforms, internal systems, and CRMs.
  • Oversee workflow orchestration using n8n or similar automation tools (optional).
  • Collaborate with product, business, and operations teams to translate requirements into AI solutions.
  • Conduct code reviews, design reviews, and ensure high-quality, scalable AI implementations.
  • Monitor AI system performance, troubleshoot issues, and optimize agent behavior.
  • Ensure adherence to security, scalability, and responsible AI standards.

Required Skills & Qualifications:

  • Bachelor’s degree in computer science, Artificial Intelligence, Engineering, or a related field.
  • 6–7 years of relevant experience in AI, ML, or software development.
  • Strong expertise in Prompt Engineering with experience leading teams.
  • Solid understanding and hands-on experience with Agentic AI concepts and implementations.
  • High proficiency in Python and development using VS Code.
  • Extensive experience with API integrations, RESTful services, and third-party platforms.
  • Strong logical thinking, system design, and debugging skills.
  • Excellent verbal and written communication skills with leadership capabilities.

Preferred Qualifications:

  • Experience using n8n or similar low-code / workflow automation tools.
  • Exposure to conversational AI, voice AI, or AI-driven automation systems.
  • Experience integrating AI workflows with enterprise platforms or CRMs.
  • Prior experience in leading AI teams or acting as a technical lead.
  • Background in domains such as customer service, healthcare, or enterprise automation is a plus.
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