Key ResponsibilitiesClaim Follow-Up & Payer Communication

- Outbound Payer Calls: Initiate direct contact with US insurance companies to investigate outstanding, pending, or delayed claims.
- Online Portal Traversal: Monitor claims statuses efficiently through insurance web portals, clearhouses, and Interactive Voice Response (IVR) systems.
- Aging Report Management: Track and prioritize accounts receivable aging buckets (e.g., 30, 60, 90+ days) to keep days sales outstanding (DSO) at a minimum.

Denial & Rejection Management

- Root Cause Analysis: Review Explanation of Advantages (EOB) and Electronic Remittance Advice (ERA) to decode complex denial codes (e.g., coordination of benefits, prior authorization, medical necessity).
- Appeals Processing: Draft, compile, and submit formal appeal letters along with necessary clinical documentation to overturn wrongful insurance denials.
- Corrected Claims: Modify demographic info, adjust modifiers, or correct coding errors to resubmit clean claims.

Documentation & Workflow

- System Logging: Maintain meticulous, clear, and compliant action notes within the billing software for audit trails.
- Internal Routing: Escalate unresolved coding, credentialing, or patient-balance issues to the respective internal departments.

Required Skills & Qualifications

- Experience:



4 to 8 years of dedicated experience in US Healthcare Accounts Receivable calling and denial management.
- Domain Expertise: Deep understanding of the US healthcare system, including commercial payers (e.g., Aetna, BCBS, UnitedHealthcare) and government programs (Medicare, Medicaid).
- Medical Coding Knowledge: Strong familiarity with ICD-10, CPT, and HCPCS coding systems, as well as HIPAA compliance laws.
- Voice & Language Proficiency: Exceptional verbal English communication skills, with neutral diction suitable for interacting professionally with US-based insurance representatives.
- Technical Skills: Experience using medical billing software (such as eClinicalWorks, Epic, AdvancedMD, or Kareo) and proficiency in MS Excel for managing claim logs.

Work Environment

- Shift Schedule: Requires working in US night shifts (typically matching Eastern, Central, or Pacific business hours).
- Location & Infrastructure: Positions are commonly available in major Indian IT/BPO hubs (like Chennai, Bangalore, or Hyderabad) and often feature office-based or hybrid structures accompanied by company-provided transport.

Pay: ₹30,000.00 - ₹60,000.00 per month

Benefits:

- Health insurance
- Paid time off
- Provident Fund

Work Location: In person

📌 Senior AR Caller (Chennai)
🏢 Sustainable Medical Billing
📍 Chennai