Job Summary

We are looking for an experienced AR Caller / Medical Billing Specialist with strong knowledge of the end-to-end US Healthcare Revenue Cycle Management (RCM) process and hands-on experience in Professional Billing (CMS-1500) and Hospital/Institutional Billing (UB-04).

The ideal candidate should have excellent expertise in AR follow-up, denial management, claims resolution, insurance calling, payment reconciliation, and client handling. The candidate must be capable of managing claims from submission through final resolution while maintaining strong communication with US healthcare clients, insurance carriers, providers, and internal teams.

Key Roles & Responsibilities

- Manage end-to-end US Healthcare RCM activities for both professional and institutional claims.
- Perform AR follow-up on CMS-1500 and UB-04 claims to ensure timely reimbursement.
- Contact insurance companies to determine claim status, payment status, denial reasons, pending information, and reimbursement issues.
- Analyze and resolve denied, rejected, underpaid, and unpaid claims.
- Review EOBs, ERAs, remittance information, payer correspondence, and claim details to identify root causes.
- Handle denials related to eligibility, authorization, medical necessity, coding, bundling, timely filing, duplicate claims, COB, non-covered services, and other payer-specific issues.
- Take appropriate action on claims, including rebilling, corrections, appeals, reconsiderations, and documentation requests.
- Maintain accurate follow-up notes and ensure appropriate next-action dates for outstanding AR.
- Work on aging AR, prioritizing high-value, high-risk, and aging claims.
- Understand the complete claim lifecycle, including patient registration, eligibility, charge entry, coding, claim submission, payment posting, denial management, AR follow-up, appeals, and account resolution.




- Demonstrate working knowledge of CMS-1500 skilled claims and UB-04 institutional claims, including major claim fields and billing requirements.
- Identify trends in denials and recurring payer issues and recommend corrective actions.
- Coordinate with coding, billing, payment posting, eligibility, authorization, and clinical/operations teams to resolve claim issues.
- Meet defined productivity, quality, accuracy, collection, and turnaround-time targets.
- Maintain compliance with HIPAA and applicable US healthcare regulations and client-specific policies.
- Provide regular updates on AR status, denial trends, collection performance, and unresolved accounts.
- Handle escalations professionally and support client requirements with strong attention to detail.
- Communicate effectively with US healthcare clients, insurance representatives, providers, and internal stakeholders.
- Maintain a high level of professionalism while handling sensitive patient and billing information.
- - Strong understanding of US Healthcare Revenue Cycle Management (RCM).
- Hands-on experience with AR calling and insurance follow-up.
- Experience handling both CMS-1500 and UB-04 claims is preferred.
- Strong denial management and claims resolution experience.
- Good knowledge of US insurance processes, payer guidelines, claim adjudication, EOB/ERA, and appeals.
- Excellent understanding of the complete medical billing and RCM lifecycle.
- Strong analytical and problem-solving skills.
- Excellent verbal and written communication skills.
- Strong US healthcare client-handling and stakeholder-management experience.
- Ability to work independently and manage multiple accounts/work queues.
- Good knowledge of MS Office and medical billing/RCM applications.

iMMEDIATE JOINER CAN APPLY FOR THIS JOB

contact details is - (phone hidden) /[email protected]

📌 Senior AR Caller (Chennai)
🏢 Q Way Technologies
📍 Chennai