Job Description :

• Experienced AR Caller Great Career Opportunity

  Job Description

  The main "Revenue Recovery & Claims Resolution Anchor" for our healthcare billing operations is the AR Caller Revenue Cycle Management (RCM), Medical Billing, Denials Management & Insurance Claims Follow-Up Specialist. Your main responsibilities are to follow up on outstanding accounts receivable, look into unpaid or denied medical claims, speak with US healthcare insurance payers directly, and ensure prompt reimbursements for healthcare providers while medical coders assign diagnostic codes and billing specialists submit initial claims. In your capacity as the "Guardian of Cash Flow, Claim Appeal Resolution, Denial Mitigation, and Zero Uncollected Revenue," you assume direct responsibility for settling outdated insurance claims.

   

  Responsibilities:

  Insurance Follow-Up & Claim Status Enquiries: To find out the current status of pending, underpaid, or delayed medical billing claims, make outgoing calls to US healthcare insurance firms and use payer web portals.

  Denial Management & Root-Cause Investigation: Examine claim denials and rejections, identify specific root reasons, and implement remedial measures.

  Appeals & Corrective Claim Resubmission: Within payer-specific timely filing constraints, draft formal claim appeals, gather required medical documentation, rectify billing, and resubmit corrected claims.

  EOB/ERA Interpretation & Patient/Payer Responsibility Allocation: Examine Electronic Remittance Advices and Explanations of Benefits to confirm accurate payment posting, deductible/coinsurance application, and contractual modifications.

  HIPAA Compliance & Quality Assurance: During all insurance phone calls and data logging operations, rigorously abide by the Health Insurance Portability and Accountability Act regulations, Protected Health Information guidelines, and corporate quality requirements.

   

  Skills:

  US Revenue Cycle Management (RCM), medical billing procedures, claim lifecycles, clearinghouse operations, and main insurance payer policies (Medicare, Medicaid, HMO/PPO plans) are all well-understood.

  Proficiency in Denial and Appeal Handling: Proficiency in deciphering denial codes, troubleshooting intricate claim rejections, and crafting persuasive appeal letters.

  Medical Terminology & Coding Awareness: Knowledge of UB-04/CMS-1500 claim forms, EOB/ERA line-item details, and fundamental CPT, HCPCS, and ICD-10 coding guidelines.

  Communication & Phone Etiquette: Strong negotiating and active listening skills, as well as excellent written and spoken English communication skills, are essential when interacting with insurance personnel.

   

  We invite you to apply and explore this exciting opportunity!

  Warm Regards,

  HR - Maria

  88708 33430

  infohrmaria04@gmail.com