Job highlights

- . Should be versatile to work in anyUS time zones (Eastern / Mountain / Central / Pacific / Hawaii) on a rotational basis (predominantly a night shift job)
- Should have a very strong verbal and written communication skill with the ability to speakconfidently and interact with the insurance representativeson the phone calls with confidentiality and following the HIPAA compliance
- Should have a very strong verbal and written communication skill with the ability to speakconfidently and interact with the insurance representativeson the phone calls with confidentiality and following the HIPAA compliance.
- Ability to grasp allthe information on the phone calls with attention to detailsand without missing out any information and document the same in tools like MS Word, Excel, PDF and any client applications and upload the same in shared drives.
- Ability to read, understand and respond / reply to the emails & chatswith a decent typing speed.
- Should be able to escalate any complex situations to supervisors immediately for resolutions.
- Should be able to understand the appropriateness of the information collected from the insurance representative and ability to check ifthe information given by the insurance representative is inadequate or unclear and recollect / recheck the information as per the requirements of the client / process.
- Should have a explicit understanding on basic Eligibility & Benefits terminologies like Co-ordination of Benefits, COBRA policies, ACA Policies, Exchange Policies, State restrictions, etc and various patient responsibilities like Co-insurance, Co-pay, Deductible, Out of Pocket responsibilities.
- Should possessknowledgeon various plan types like HMO PPO, POS, EPO,



and other type plans set by insurance companies.
- Should be able to navigate through the variousEMRs, Insurance portals, IVR / AVR systems to collect the eligibility and benefits information andthen perform outbound phone calls to Benefits department of the insurance companies in the United Statesto get all required eligibility and benefits information
- Should be also able to make phone calls Authorization / Utilization Review Department and initiate and get Authorizationapprovals if required for a service, should be able to fax the records andmake subsequent follow-ups if authorization requests are denied.
- Ensuring accurate and timely completion of each Verification request within the given TATs and SLAs set by the organization & client.
- Should be flexible to work on multiple client / process each day without any hesitations.
- Should be flexible to work in anyUS time zones (Eastern / Mountain / Central / Pacific / Hawaii) on a rotational basis (predominantly a night shift job).
- Should be flexible to work on any 5 days in a week with off on any 2 days of the week.
- Should be punctual with the designated shift timings and avoid unnecessary and frequent leaves
- Should be able to prioritize and manage the daily workflow of verification requests from the different clients / process and should beable to work both independently and as well as in a team environment.
- Added advantage for candidates who have previously worked on Behavioural Health, Mental Health Substance Abuse specialities
- Candidates who have worked on getting only the effective date and termination date of policy through insurance portals and have not made phone calls need not apply for this job

📌 AR Caller (Mumbai)
🏢 Acme Services
📍 Mumbai