Full Description
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Job Description
In medical billing, the AR Caller is a specialist in finance who works with US-based insurance companies to settle medical claims that have been denied or unpaid. Your main goal is to reduce the number of "Days in AR" and increase healthcare providers' collections. You will be an unwavering supporter of the revenue cycle, figuring out why claims are stalled—whether because of coding mistakes, a lack of medical necessity, or benefit coordination—and taking the required steps to get them paid. Excellent negotiating abilities, a "never-give-up" attitude against insurance adjusters, and a thorough awareness of the US healthcare system are all characteristics of the ideal candidate.
Responsibilities
Claims Follow-up: In order to ascertain the present state and anticipated date of payment for pending or outstanding claims, proactively contact insurance firms (Payers).
Denial Management: Examine "Electronic Remittance Advice" (ERA) and "Explanation of Benefits" (EOB) to determine the causes of claim denials and implement remedial measures.
Processing Appeals: Write and send official appeal letters, along with the required
medical records, to insurance companies when claims are wrongfully rejected.
Analyze payment variances to find instances in which insurance companies have underpaid based on agreed-upon rates and collect the outstanding amount.
Data Correction: To fix demographic, CPT, or ICD-10 code problems that are leading to claim denials, collaborate with the coding and billing teams.
Payer Knowledge: Keep abreast of the various insurance kinds, as well as their particular filing restrictions and reimbursement guidelines.
Skills:
Knowledge of US healthcare: familiarity with RCM terminology, HIPAA laws, and the distinction between "In-Network" and "Out-of-Network."
Verbal Communication: Able to interact with insurance professionals and speak English well with a neutral accent.
Analytical Ability: The capacity to spot trends in rejections and recommend process enhancements that stop rejects in the future.
Persistence: The capacity to stay focused while navigating intricate IVR (Interactive Voice Response) systems and extended hold periods.
We invite you to apply and explore this exciting opportunity!
Warm Regards,
HR - Maria
88708 33430
infohrmaria04@gmail.com