22 Oct
|
Atean Healthcare Solutions
|
Chennai
22 Oct
Atean Healthcare Solutions
Chennai
Job Description
– AR Caller (Medical Billing – Insurance Process) Job Title: AR Caller – Accounts Receivable Department: Medical Billing / Revenue Cycle Management (RCM)
Experience:
1–3 Years (Experienced Candidates) Process: US Healthcare – Insurance Follow-up Shift: Night Shift Employment Type: Full-Time Job Summary We are looking for a motivated and detail-oriented AR Caller to join our Medical Billing team. The candidate will be responsible for following up with US insurance companies regarding outstanding claims, resolving claim denials, identifying payment delays, and ensuring timely reimbursement to healthcare providers. The ideal candidate should have strong communication, analytical, and problem-solving skills, along with knowledge of US healthcare insurance processes. Roles and Responsibilities 1. Insurance Follow-up: Contact US insurance companies through outbound calls to check the status of pending and outstanding medical claims. 2. Claim Status Verification: Verify claim status, payment details, processing timelines, and reasons for non-payment with insurance representatives. 3. Denial Management: Identify claim denials and rejections, understand the reasons, and take appropriate action to resolve them. 4. Accounts Receivable Management: Work on assigned AR accounts and follow up on outstanding claims to ensure timely payment collection. 5. Claim Resolution: Coordinate with the relevant internal teams to resolve claim-related issues, including missing information, coding errors, eligibility concerns, and authorization issues. 6. Appeals and Reconsiderations: Initiate or coordinate appeals, reconsiderations, and claim resubmissions based on insurance company guidelines. 7. Documentation: Maintain accurate records of insurance calls, claim status, payment details, denial reasons, and follow-up actions in the billing system. 8. Insurance Coordination:
Communicate professionally with insurance representatives to obtain accurate information and resolve reimbursement issues. 9. Follow-up Tracking: Maintain timely follow-up on pending claims and ensure accounts are worked within the prescribed timelines. 10. Productivity and Quality: Meet daily productivity targets, call quality standards, collection goals, and other performance metrics set by the organization. 11. Issue Escalation: Escalate complex or unresolved claims to the appropriate team leader or manager for further action. 12. Compliance: Follow HIPAA requirements, client-specific guidelines, company policies, and data confidentiality standards while handling patient and insurance information. 13. Reporting: Prepare and update reports on claim follow-ups, outstanding accounts, denials, and resolved claims as required. Required Skills and Qualifications
- Any graduate degree from a recognized university.
- 1–3 years of experience in US medical billing, preferably in AR calling or insurance follow-up.
- Positive verbal communication skills and confidence in handling international voice calls.
- Knowledge of US healthcare insurance processes and medical billing terminology.
- Basic understanding of claim denials, EOBs (Explanation of Benefits), ERAs (Electronic Remittance Advice), and claim status codes.
- Ability to analyze claim issues and identify appropriate resolution steps.
- Good documentation, time management, and problem-solving skills.
- Basic computer knowledge and proficiency in MS Excel.
- Ability to work night shifts and meet process-specific productivity and quality targets. Key Performance Indicators (KPIs)
- Daily call volume and account handling.
- Claims resolved and payments recovered.
- AR aging reduction and follow-up effectiveness.
- Denial resolution and appeal follow-up accuracy.
- Quality scores and documentation accuracy.
- Adherence to process guidelines and turnaround times.
📌 AR Caller – US Medical Billing (Chennai)
🏢 Atean Healthcare Solutions
📍 Chennai