Senior Ar Caller

Role & responsibilities

• Insurance Follow-ups:
  Contact insurance companies (via calls or portals) to check the status of pending medical claims.
• Claim Status Verification:
  Review and verify claim details, payment status, denials, and rejections.
• Denial Management:
  Analyze reasons for claim denials and take necessary actions such as re-submission or escalation.
• Payment Posting Support:
  Assist in identifying underpayments or overpayments and report discrepancies.
• Accounts Receivable Management:
  Work on assigned AR queues to reduce outstanding balances and improve cash flow.
• Documentation:
  Accurately document call details, claim updates, and actions taken in the system.
• Appeals & Reprocessing:
  Initiate appeals for denied claims and follow up until resolution.
• Timely Follow-ups:
  Ensure regular follow-ups on unpaid or partially paid claims within TAT (Turnaround Time).
• Compliance:
  Maintain compliance with HIPAA guidelines and company policies.
• Coordination:
  Work closely with billing, coding, and internal teams to resolve claim issues.
• Productivity & Quality Targets:
  Meet daily/weekly/monthly targets in terms of calls, collections, and quality standards.
• Good communication and negotiation skills
• Knowledge of US healthcare/medical billing process
• Understanding of insurance policies and denial codes
• Basic computer skills (Excel, billing software)
• Attention to detail and problem-solving ability

Preferred candidate profile

• Educational Qualification:
  Any graduate (Commerce / Life Sciences / Pharmacy background is an advantage)
• Communication Skills:
  Excellent verbal communication skills with neutral accent and good listening ability
• Process Knowledge:
  Strong understanding of medical billing, insurance claims, denial management, and AR follow-ups
• Technical Skills:
  Basic knowledge of MS Excel and medical billing software/tools
• Analytical Skills:
  Ability to analyze claim denials and take appropriate action for resolution
• Work Flexibility:
  Willingness to work in night shifts (US timings)
• Target-Oriented:
  Ability to meet productivity, quality, and collection targets
• Team Player:
  Good interpersonal skills and ability to coordinate with internal teams
• Adaptability:
  Quick learner with the ability to handle multiple tasks and work under pressure