Full Description
AR Caller The RCM Industries Development Course
Job Description
Recovering unpaid invoices from insurance companies is the responsibility of the AR Caller, a crucial component in the Revenue Cycle Management (RCM) chain. Your main goal is to aggressively follow up on unsettled or refused claims in order to reduce the aging of accounts receivable. You are more than simply a "caller"; you are a dedicated investigator who is knowledgeable about insurance regulations, can determine the reason a claim hasn't been paid, and will take the required actions to settle it. The ideal applicant is very persistent, has outstanding communication skills, and is able to use complicated phone systems and insurance websites.
Responsibilities
Insurance Follow-up: To find out the status of pending claims, call or visit insurance providers' websites.
Denial Resolution: Determine the cause of claim rejections and act right once to resubmit, file an appeal, or make the necessary corrections.
Documentation: To guarantee a transparent audit trail of the discussion with the insurance representative, keep thorough notes in the billing system for each step taken.
Patient
Responsibility Identification: Notify the patient billing team of any claims where the patient should be responsible for the remaining amount.
Submission of an Appeal: Write and submit official appeal letters, including any required medical documentation or coding explanations, to insurance companies when a claim is unjustly rejected.
Data Integrity: To fix mistakes that impede the processing of claims, confirm patient demographics, insurance eligibility, and authorization information.
Skills:
Effective and professional verbal communication is essential when negotiating with insurance adjusters.
Knowledge of US Healthcare: Knowledge of Medicare/Medicaid, HIPAA laws, and private payer policies (UnitedHealth, Aetna, Cigna).
EOB/ERA Literacy: The capacity to read and comprehend an explanation of benefits in order to distinguish between denial, adjustment, and payment.
The ability to determine the "root causes" of a claim's stalemate and come up with a remedy instead of merely requesting status.
We invite you to apply and explore this exciting opportunity!
Warm Regards,
HR - Maria
88708 33430
infohrmaria04@gmail.com