Eligibility Verification / AR Caller (US Healthcare RCM)

Job Title: Eligibility Verification / AR Caller (US Healthcare RCM)

Experience: 1–2 Years

Location: Coimbatore

Department: Revenue Cycle Management (RCM)

Employment Type: Full-Time

Job Summary

We are looking for a motivated and detail-oriented Eligibility Verification / AR Caller

with 1–2 years of experience in US Healthcare Revenue Cycle Management. The ideal

candidate should have hands-on experience in insurance eligibility verification and/or

Accounts Receivable (AR) calling, with strong communication skills and knowledge of

US healthcare insurance processes.

Key Responsibilities

Eligibility Verification

• Verify patient insurance eligibility and benefits through payer websites and

insurance portals.

• Contact insurance companies to confirm coverage, policy status, co-pay, coinsurance, deductible, and out-of-pocket details.

• Verify authorization and referral requirements prior to patient appointments.

• Document eligibility findings accurately in the practice management system.

• Identify inactive or invalid insurance coverage and escalate issues when

required.

• Ensure eligibility is completed within client-defined turnaround time.

Accounts Receivable (AR) Calling

• Contact insurance companies regarding outstanding claims.

• Follow up on denied, rejected, and pending claims.

• Analyze denial reasons and take appropriate corrective actions.

• Update claim status and call notes in the billing system.

• Coordinate with internal teams to resolve claim-related issues.

• Meet daily productivity and quality targets.

Required Skills

• 1–2 years of experience in US Healthcare RCM.

• Knowledge of Commercial, Medicare, and Medicaid insurance plans.

• Good understanding of:

o Eligibility & Benefits Verification

o AR Calling

o Claim Status

o Denial Management

o Prior Authorization (preferred)

• Excellent verbal communication skills.

• Strong analytical and problem-solving abilities.

• Good typing speed and computer proficiency.

• Ability to work in night shifts.

Preferred Knowledge

• HIPAA Compliance

• CPT, ICD-10, and HCPCS coding basics

• Insurance Portals

• EMR / EHR / Practice Management Systems

• Clearinghouses (Availity, Navinet, etc.)

Key Competencies

• Attention to Detail

• Effective Communication

• Customer Focus

• Time Management

• Team Collaboration

• Problem Solving

• Quality Orientation

• Accountability

Key Performance Indicators (KPIs)

• Daily Eligibility Verification Productivity

• AR Calls per Day

• Claims Resolved

• First Call Resolution

• Quality Score

• Accuracy

• Turnaround Time (TAT)

• Client SLA Adherence

Interested candidates share your updated resume to [HIDDEN TEXT].