We are seeking a detail-oriented and Experienced AR Caller to join our revenue cycle management(RCM) team.
The ideal candidate will be responsible for performing analysis and follow-up on unpaid or denied medical claims with U.S.-based insurance companies.
The role demands deep knowledge of healthcare reimbursement processes, excellent communication skills, and a proactive approach to ensure timely and complete collection of accounts receivable.
Key Responsibilities:
Insurance Follow-Up & Collections
? Initiate outbound calls to insurance carriers to check the status of outstanding claims.
? Analyse reasons for claim delays, denials, or underpayments and take corrective actions.
? Follow up on claims via phone calls, web portals, and payer correspondence tools.
? Work claims from aging buckets (30/60/90/120+ days) to reduce outstanding AR.
2. Denial Management & Resolution
? Identify trends in denials such as eligibility issues, authorization lapses, incorrect coding, or missing documentation.
? Collaborate with internal billing or coding teams to reprocess or appeal denied claims.
? Initiate and track appeals, re-submissions, and corrected claims as necessary.
? Ensure timely handling of denials to prevent timely filing limits from being breached.
3. Documentation & System Updates
? Accurately document every call made, including representative details, outcome, and next stepsin the billing or practice management system.
? Maintain clear, concise, and up-to-date account notes to ensure transparency across the team.
? Update claim statuses and escalate unresolved issues for additional action.
4. Compliance & Quality Assurance
? Ensure all interactions comply with HIPAA and payer-specific requirements.
? Maintain a high call quality standard and meet internal compliance guidelines and client SOPs.
? Adhere strictly to privacy and data security protocols in every interaction.
5. Performance & Reporting
? Meet or exceed daily productivity benchmarks such as call volume, resolution rate, and aging reduction.
? Participate in team meetings, training sessions, and performance reviews.
? Provide feedback on payer behavior and denial trends to help refine process strategies.6.
Team Collaboration
? Work closely with Team Leads, QA, and other AR staff to resolve complex claims or systemic issues.
? Contribute to shared knowledge and assist peers with troubleshooting payer-specific challenges.
? Stay informed about payer policy changes and communicate relevant updates to the team.
Required Skills:
? Minimum 1 year to 5 years of hands-on experience in AR calling and medical billing follow-up in the U.S. healthcare domain.
? Familiarity with insurance companies such as Medicare, Medicaid, and Commercial payers.