Hays · 1 week ago
Senior Process Executive – Accounts Receivable
United States
Contract
Remote
Mid, Senior Level
$22/hr - $25/hr
1+ years expHays is seeking a Senior Process Executive – Accounts Receivable responsible for managing and optimizing the full lifecycle of hospital and professional claims across third-party payers. The role requires advanced knowledge of US healthcare billing, claims adjudication, and payer-specific requirements to ensure timely and accurate reimbursement for healthcare services.
Information ServicesRecruitingStaffing Agency
No H1B
Hiring Manager
Manoj Kumar
Responsibilities
Manage accounts receivable processes for hospital and professional claims, ensuring compliance with US payer regulations
Analyze and resolve outstanding claims, including denials and underpayments, using payer-specific portals and resources
Investigate root causes of denials, apply appropriate ICD-10 and CPT codes, and implement corrective actions to maximize reimbursement
Prepare and submit appeals to insurance companies and Medicare, including redetermination requests and supporting documentation
Perform online submission of claims and monitor claim status through portals
Review aged receivables, recommend write-offs for uncollectible accounts, and report findings to the Account Manager
Maintain up-to-date knowledge of payer policies, federal and state regulations (HIPAA, CMS guidelines), and industry best practices
Collaborate with internal teams and external payers to resolve complex claim issues and expedite payment
Qualification
Required
Bachelor's degree or equivalent experience required; preferred in Business, Healthcare Administration, or related field
Minimum 1–2 years of hands-on experience in US healthcare revenue cycle management, with a focus on hospital and professional claims
In-depth understanding of UB-04 and CMS-1500 claim forms, ICD-10, CPT/HCPCS coding, and payer guidelines
Exceptional communication and interpersonal skills; able to interact professionally with payers, providers, and team members
Strong problem-solving and critical thinking abilities, with attention to detail and accuracy
Demonstrated ability to prioritize tasks, manage multiple deadlines, and adapt to changing regulatory requirements
High level of integrity, work ethic, and commitment to organizational goals
Proficiency in healthcare billing software, payer portals, and Microsoft Office Suite
Experience with US hospital billing systems (Epic, Cerner, Meditech, etc.)
Familiarity with payer regulations, including appeals and redetermination processes
Ability to work independently and as part of a collaborative team
Benefits
Full medical benefits
Dental benefits
Vision benefits
401K
Life Insurance ($20,000 benefit)
Company
Hays
Hays is a leading global professional recruiting group, they are expert at recruiting qualified, professional and skilled people worldwide. It is a sub-organization of Hays plc.
5001-10000 employees
Funding
Current Stage
Late StageLeadership Team
Manu Saigal
Country Manager - India
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