Role & responsibilities
Insurance Follow-ups: Contact insurance companies (via calls or portals) to check the status of pending medical claims.
Claim Status Verification: Review and verify claim details, payment status, denials, and rejections.
Denial Management: Analyze reasons for claim denials and take necessary actions such as re-submission or escalation.
Payment Posting Support: Assist in identifying underpayments or overpayments and report discrepancies.
Accounts Receivable Management: Work on assigned AR queues to reduce outstanding balances and improve cash flow.
Documentation: Accurately document call details, claim updates, and actions taken in the system.
Appeals & Reprocessing: Initiate appeals for denied claims and follow up until resolution.
Timely Follow-ups: Ensure regular follow-ups on unpaid or partially paid claims within TAT (Turnaround Time).
Compliance: Maintain compliance with HIPAA guidelines and company policies.
Coordination: Work closely with billing, coding, and internal teams to resolve claim issues.
Productivity & Quality Targets: Meet daily/weekly/monthly targets in terms of calls, collections, and quality standards.
Valuable communication and negotiation skills




Knowledge of US healthcare/medical billing process
Understanding of insurance policies and denial codes
Basic computer skills (Excel, billing software)
Attention to detail and problem-solving ability

Preferred candidate profile
Educational Qualification: Any graduate (Commerce / Life Sciences / Pharmacy background is an advantage)
Communication Skills: Excellent verbal communication skills with neutral accent and good listening ability
Process Knowledge: Robust understanding of medical billing, insurance claims, denial management, and AR follow-ups
Technical Skills: Basic knowledge of MS Excel and medical billing software/tools
Analytical Skills: Ability to analyze claim denials and take appropriate action for resolution
Work Flexibility: Willingness to work in night shifts (US timings)
Target-Oriented: Ability to meet productivity, quality, and collection targets
Team Player: Valuable interpersonal skills and ability to coordinate with internal teams
Adaptability: Quick learner with the ability to handle multiple tasks and work under pressure

📌 Senior Ar Caller Hyderabad (India)
🏢 Lumeratek
📍 India