Job Description

We are seeking a skilled and professional

Spanish Caller - RCM

to join our growing healthcare BPO team. The ideal candidate will be fluent in both

Spanish and English

and will be responsible for making outbound calls to insurance companies, patients, and healthcare providers to follow up on medical claims and ensure timely resolution.

This role is crucial in supporting the

RCM process

, ensuring accurate reimbursements and maintaining excellent client satisfaction.

Key Responsibilities:

Conduct outbound calls in

Spanish and English

to insurance providers to check claim status and follow up on unpaid or denied claims. Communicate with patients, hospitals, and medical offices to gather or clarify billing information. Analyze and understand EOBs (Explanation of Benefits) and insurance correspondences. Work with the RCM team to identify and resolve issues affecting cash flow and revenue. Update billing systems with call notes, claim statuses, and next steps. Meet daily, weekly, and monthly productivity and quality targets. Maintain compliance with HIPAA and other healthcare data privacy regulations. Collaborate effectively with internal departments to escalate or resolve complex cases.

Required Skills and Qualifications:

Fluency in

Spanish and English

(spoken and written) is mandatory. 1-3 years of experience in

medical billing

,

RCM

, or

healthcare calling processes

. Knowledge of US healthcare insurance terms (Medicare, Medicaid, PPO, HMO, etc.). Strong communication and interpersonal skills. Experience with billing software (e.g., AdvancedMD, Kareo, eClinicalWorks, or similar) is a plus. Attention to detail and strong analytical skills. Ability to work independently and manage time effectively.

Preferred Qualifications:

Experience working in a US healthcare BPO environment. Understanding of CPT, ICD-10, and HCPCS codes. Familiarity with denial management and AR follow-up.
Job Type: Full-time

Pay: ₹500,000.00 - ₹800,000.00 per year

Work Location: In person