Job Description

Job Title

AR Caller (Accounts Receivable - US Healthcare)

Location

Pranava Group, beside Harsha toyota showroom, Kothaguda, Telangana 500084| Shift: US Shift (Night) | Employment: Full-time

About the Role

As an AR Caller, you will follow up with US insurance payers and patients to resolve unpaid/denied medical claims, accelerate collections, and reduce days in A/R. You'll work closely with billing/coding teams to ensure timely, accurate reimbursement.

Key Responsibilities

Place outbound calls to insurance companies and patients to follow up on unpaid/underpaid/denied claims. Review EOBs/ERAs, payer portals, and practice management systems to identify issues and next actions. Analyze denials (CO/PR codes), determine root causes, and initiate corrective steps (appeals, resubmissions, coding fixes). Document call outcomes and next actions in the billing system with accurate notes and dispositions. Escalate complex cases (medical necessity, coding discrepancies, timely filing risk) to billing/coding teams. Track and work aging buckets (0-30, 31-60, 61-90, 90+ days) to reduce AR and improve cash flow. Adhere to payer-specific guidelines, TATs, and timely filing limits. Maintain HIPAA compliance and patient data confidentiality. Meet or exceed daily/weekly productivity and quality targets.
Required Qualifications

1-3 years of US healthcare AR calling / RCM experience (physician or hospital billing). Strong understanding of the claims lifecycle, CPT/ICD modifiers at a working level, denial codes, EOB/ERA reading. Excellent spoken English and call handling skills; confident on outbound payer calls. Proficiency with billing/PM systems (e.g., Kareo, Athena, eClinicalWorks, AdvancedMD, NextGen, or similar) and MS Excel. Ability to work US time zones and meet aggressive SLAs.
Preferred (Nice to Have)

Experience with payer portals (UHC, Aetna, Medicare, Medicaid, BCBS, etc.). Knowledge of appeals writing and reconsideration processes. Exposure to specialties (e.g., Radiology, Anesthesia, DME, PT/OT, Behavioral Health). Certified Professional Coder (CPC-A/CPC) or RCM certifications (preferred, not mandatory).
Key Skills

Denial management & AR follow-up Problem solving & negotiation Attention to detail & documentation Time management & prioritization Customer focus and professionalism HIPAA compliance awareness
Performance Metrics (KPIs)

Calls per day / Right Party Contacts (RPC) Promise-to-pay kept rate & $ collected AR days reduction & % AR >90 reduced Denial overturn rate / Appeal success rate First-call resolution & QA score
Job Types: Full-time, Permanent, Fresher

Pay: ?350,000.00 - ?450,000.00 per year

Benefits:

Health insurance Provident Fund
Work Location: In person