Job Description :

• Customer Relations Agent at US Healthcare AR

  Job Description

  The primary "Frontline Collection Anchor, Insurance Voice Specialist, Claim Status Engine & Revenue Recovery Guardian" for our medical billing and Revenue Cycle Management (RCM) operations is the AR Caller in Medical Billing Insurance Claim Follow-Up, Rejection Resolution, Claim Status Checking & Revenue Cycle Operations Specialist. While A/R managers and RCM directors set monthly revenue targets, client service level agreements (SLAs), and macro financial strategies, your main responsibility is to actively contact US insurance representatives, confirm the status of claim processing, address clearinghouse rejections, and ensure timely claim adjudication. As the "Guardian of Voice Follow-Up Efficiency, Insurance Escalation, Claim Resolution Speed, and Cash Flow Acceleration," you assume direct execution responsibility for transferring outstanding claims from pending to final payment.

   

  Responsibilities:

  Outbound Insurance Follow-Up Calling: Make direct outbound phone calls to US government and commercial insurance agents to find out about overpaid, postponed, or denied medical claims.

  Claim Status & Adjudication Verification: Use voice calls, interactive voice response (IVR) systems, and payer online portals to ascertain the exact claim adjudication status (received, in-process, denied, paid, short-paid).

  Frontline Rejection & Denial Handling: Take prompt corrective action or request claim re-adjudication when you discover missing demographic information, wrong insurance IDs, missing pre-authorizations, or billing problems during calls.

  Secondary Billing & COB Escalation: Update Coordination of Benefits (COB) data, request balance transfers, start secondary insurance billing, and confirm primary payment details.

  Call Documentation & Queue Management: Update claim action codes, reference numbers, and follow-up dates in the Medical Billing/Practice Management (PM) software by keeping thorough, consistent call notes.

   

  Skills:

  Spoken English and Professional Voice Communication: Proficient verbal English communication abilities, a neutral accent, and appropriate phone manners for interacting with US-based insurance agents and medical professionals.

  US Insurance Payer Knowledge: Timely filing requirements, typical denial words, and a strong working knowledge of the main US health insurance payers.

  PM System & Payer Portal Command: Practical experience using web portals and medical billing/PM software (Availity, Navinet).

  Call Confidentiality and HIPAA Adherence: Strict compliance with protected health information (PHI) requirements, HIPAA data privacy regulations, and secure call handling protocols.

   

  We invite you to apply and explore this exciting opportunity!

  Warm Regards,

  HR - Maria

  88708 33430

  infohrmaria04@gmail.com