27 Aug
|
Tech Lead RCM
|
Chennai
27 Aug
Tech Lead RCM
Chennai
Job Summary:
We are seeking a detail-oriented and Experienced AR Caller to join our revenue cycle management(RCM) team.
The ideal candidate will be responsible for performing analysis and follow-up on unpaid or denied medical claims with U.S.-based insurance companies.
The role demands deep knowledge of healthcare reimbursement processes, excellent communication skills, and a proactive approach to ensure timely and complete collection of accounts receivable.
Key Responsibilities:
Insurance Follow-Up & Collections
Initiate outbound calls to insurance carriers to check the status of outstanding claims.
Analyse reasons for claim delays, denials, or underpayments and take corrective actions.
Follow up on claims via phone calls, web portals, and payer correspondence tools.
Work claims from aging buckets (30/60/90/120+ days) to reduce outstanding AR.
2. Denial Management & Resolution
Identify trends in denials such as eligibility issues, authorization lapses, incorrect coding, or missing documentation.
Collaborate with internal billing or coding teams to reprocess or appeal denied claims.
Initiate and track appeals, re-submissions, and corrected claims as necessary.
Ensure timely handling of denials to prevent timely filing limits from being breached.
3. Documentation & System Updates
Accurately document every call made, including representative details, outcome, and next stepsin the billing or practice management system.
Maintain explicit, concise, and up-to-date account notes to ensure transparency across the team.
Update claim statuses and escalate unresolved issues for additional action.
4. Compliance & Quality Assurance
Ensure all interactions comply with HIPAA and payer-specific requirements.
Maintain a high call quality standard and meet internal compliance guidelines and client SOPs.
Adhere strictly to privacy and data security protocols in every interaction.
5. Performance & Reporting
Meet or exceed daily product
📌 AR Caller (Chennai)
🏢 Tech Lead RCM
📍 Chennai