senior AR caller - Physician Billing

Greetings from Sutherland Global Services

Job Summary

We are seeking an experienced Accounts Receivable (AR) Caller to manage and follow up on outstanding medical/physician billing claims. The role involves contacting insurance companies and patients, researching unpaid or denied claims, resolving billing issues, and ensuring timely reimbursement.

Key Responsibilities

• Follow up with insurance companies on outstanding medical/physician claims.
• Verify claim status, payment details, denials, rejections, and pending claims.
• Contact insurance payers through phone, portals, and other appropriate channels.
• Analyze AR aging reports and prioritize accounts based on age, balance, and payer.
• Investigate and resolve claim denials, underpayments, and payment discrepancies.
• Identify denial reasons such as eligibility, authorization, coding, timely filing, and medical-necessity issues.
• Prepare and submit corrected claims, reconsiderations, and appeals when required.
• Review EOBs/ERAs and accurately interpret payer responses.
• Maintain detailed documentation of all payer follow-ups and account actions.
• Coordinate with coding, billing, payment posting, and other teams to resolve account issues.
• Escalate complex or high-value accounts appropriately.
• Ensure compliance with company policies and healthcare billing procedures.
• Meet assigned AR, productivity, quality, and collection targets.

Required Skills & Qualifications

• Bachelor's degree or relevant healthcare/medical billing qualification preferred.
• 24 years of experience in medical billing, AR calling, or physician billing preferred.
• Good knowledge of the US healthcare revenue cycle (RCM).
• Understanding of insurance claims, denials, EOBs, ERAs, CPT, ICD-10, and HCPCS.
• Knowledge of Medicare, Medicaid, and commercial insurance processes is an advantage.
• Strong verbal and written communication skills.
• Good analytical and problem-solving abilities.
• Ability to work with AR aging reports and billing software.
• Comfortable communicating professionally with insurance representatives.
• Good typing, documentation, and computer skills.
• Ability to work independently and achieve daily productivity targets.

contact HR Pranavi : [phone removed]

Note: "Sutherland never requests payment or favors in exchange for job opportunities. Please report suspicious activity immediately to [email removed]