07 Oct
|
Triage Ops
|
India
AR Caller – US Healthcare / Medical Billing
Location: Remote, Bengaluru India
Employment Type: Full-time
Experience: 1–4 years preferred
Shift: US shift / Night shift
We are hiring an experienced AR Caller – US Healthcare to manage insurance follow-ups and help recover outstanding payments from US insurance companies.
The ideal candidate should have hands-on experience with medical billing, accounts receivable follow-up, claim status, denials, appeals, and payer communication.
Responsibilities
- Call US insurance companies to follow up on unpaid, underpaid, or denied medical claims.
- Check claim status through payer portals, IVR systems, and phone calls.
- Identify reasons for non-payment or denial.
- Work on outstanding AR based on aging, balance, payer, and priority.
- Review EOBs, ERAs, denial codes, and payer responses.
- Investigate issues such as:
- Claim not received
- Claim pending
- Authorization issues
- Eligibility issues
- Coding-related denials
- Medical necessity denials
- Duplicate claims
- Timely filing
- Coordination of benefits
- Incorrect payment
- Underpayments
- Take the appropriate next action after each payer interaction.
- Request claim reprocessing when appropriate.
- Initiate or support appeals and reconsiderations.
- Follow up on previously submitted appeals and corrected claims.
- Document payer calls accurately, including:
- Claim status
- Representative name
- Call/reference number
- Denial reason
- Expected processing timeline
- Required next action
- Escalate complex claims when necessary.
- Update claim status and notes in the billing or practice management system.
- Meet productivity and quality targets while maintaining accurate documentation.
- Help identify recurring payer issues and common reasons for delayed payment.
Requirements
- 1+ years of experience as an AR Caller or AR Follow-up Executive in US healthcare preferred.
- Valuable understanding of the US healthcare revenue cycle.
- Familiarity with medical billing terminology.
- Understanding of:
- CPT
- ICD-10
- HCPCS
- EOB / ERA
- Denials
- Appeals
- Prior authorization
- Eligibility
- Insurance benefits
- Experience communicating with US insurance companies.
- Strong spoken English and listening skills.
- Ability to understand different US accents.
- Comfortable spending significant time on insurance calls.
- Good analytical and problem-solving ability.
- Strong attention to detail.
- Comfortable working during US business hours.
Preferred ExperienceExperience working with payers such as:
- UnitedHealthcare
- Aetna
- Cigna
- Blue Cross Blue Shield
- Humana
- Medicare
- Medicaid
- Other commercial and government payers
Experience with one or more specialties such as physician billing, hospital billing, emergency medicine, radiology, anesthesia, behavioral health, dental, or other healthcare specialties is a plus. What We Care AboutWe are less interested in how many calls you make and more interested in whether you can move claims toward payment.
A strong candidate should be able to look at an outstanding claim, understand what is blocking payment, communicate effectively with the payer, determine the correct next action, and follow the claim through until it is resolved.
We will evaluate performance using metrics such as:
- Claims successfully resolved
- Dollars recovered
- Quality of follow-up
- Accuracy of documentation
- Reduction in outstanding AR
- Ability to independently handle payer issues
📌 AR Caller – US Healthcare / Medical Billing (India)
🏢 Triage Ops
📍 India