Business Unit:
Resolv was formed in 2022, bringing together a suite of industry-leading healthcare revenue cycle leaders with over 30 years of industry expertise, including Ultimate Billing, First Pacific Corporation, Innovative Healthcare Systems, and Innovative Medical Management. Our DNA is rooted in revenue cycle solutions. As we continue to expand, we remain dedicated to partnering with RCM companies that offer diverse solutions and address today's most pressing healthcare reimbursement and revenue cycle operations complexities. Together, we improve financial performance and patient experience, helping to build sustainable healthcare businesses.

Job Summary:

We are seeking a detail-oriented and proactive professional to manage payer portal access and support insurance-related administrative processes. The ideal candidate will be responsible for researching payer requirements, coordinating with insurance providers, and ensuring seamless access to various payer portals for internal teams.

Work Mode: Remote
Shift Timings: 6pm-3am (Night Shift)
Location: Mumbai(Vikhroli)

Responsibilities:

Key Responsibilities:

• Research and understand payer-specific requirements for portal access and registration
• Communicate with insurance companies to gather accurate and up-to-date access procedures
• Complete portal registrations, including submission of required documentation and forms
• Set up and manage administrative accounts across payer portals
• Grant and maintain user access for internal stakeholders
• Troubleshoot portal access issues and coordinate resolutions with payers
• Maintain documentation of portal processes, credentials, and access workflows
• Collaborate with cross-functional teams to ensure timely onboarding and access management
• Ensure compliance with organizational policies and payer guidelines
• Understanding of Optum, Zelis, availity payer portal

• Strong understanding of healthcare payer systems and insurance processes
• Excellent research and problem-solving skills
• Effective communication skills, both written and verbal
• High attention to detail and organizational abilities
• Experience working with payer portals or healthcare administration preferred
• Ability to manage multiple tasks and stakeholders simultaneously
• Proficiency in MS Office and/or other administrative tools

(Mandatory Qualifications & Skills):

Graduate in Any Field

Basic RCM knowledge

AR experience of 1-2 years

Skills:

• Strong understanding of healthcare insurance plans (Medicare, Medicaid, Commercial payers).

• Proficient with payer portals (such as Availity, NaviNet, Trizetto, etc.)..

• Attention to detail with the ability to manage multiple claims and prioritize tasks effectively.

• Excellent written and verbal communication skills.

• Ability to troubleshoot and resolve issues related to claims submission or portal functionality.

Skills/ Behavioural Skills:

• Problem-Solver: Identifies and resolves healthcare billing discrepancies.

• Organized: Manages high volumes of medical remittances efficiently.

• Clear Communicator: Effectively discusses payment issues with healthcare teams.

• Analytical: Understands healthcare financial data and denial patterns.

Benefits:

• Annual Public Holidays as applicable

• 30 days total leave per calendar year

• Mediclaim policy

• Lifestyle Rewards Program

• Group Term Life Insurance

• Gratuity

• ...and more!