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.
Desired Candidate Profile:
- Minimum 18 months to 4 years of experience in Physician RCM and AR Calling.
- Good understanding of CMS-1500 claim forms and physician billing
- Familiarity with CCI, McKesson, payer portals, and Waystar.
- Experience in specialties such as Cardiology, Radiology, Gastroenterology, Pediatrics, Orthopedics, Emergency Medicine, and Surgery.
- Graduate in any discipline.
- Comfortable working in the Night Shift.
- Immediate joiners or candidates serving up to a 15-day notice period are preferred.
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📌 SR AR Caller - Physician Billing (Uppal)
🏢 Sutherland
📍 Uppal