Talent.com
No longer accepting applications
▷ Urgent : AR Callers & Denial Management, EVBV, Authorization Specialists – (Medical Billing)

▷ Urgent : AR Callers & Denial Management, EVBV, Authorization Specialists – (Medical Billing)

RevUpside Business Solutions Private LimitedMumbai, Maharashtra, India
22 hours ago
Job description

Key Responsibilities for AR :

  • Review account thoroughly, including any prior comments on the account, EOBs / ERAs / Correspondence, and perform pre-resolution analysis.
  • Understand the reason for rejection, denials, or no status from the payer.
  • Work on the resolution of the claim by performing follow-up with the payer using the most optimal method, i.e., calling, IVR, web, or email.
  • Take appropriate action to move the account towards resolution, including rebilling the claim, sending claims for reprocessing, reconsideration, redetermination, appeal (portal / web, fax, mail), verifying eligibility and benefits, and managing management hand-off with the client and internal teams.
  • Documentation of all the actions on the practice management system and workflow management system, and maintain an audit trail.
  • Ensure adherence to Standard Operating Procedures and compliance.
  • Highlight any global trend / pattern and issue escalation with the leadership team.
  • Meet the productivity and quality target on a daily / monthly basis.
  • Upskill by learning new / additional skills and enhancing competencies. Active participation in all process / client-specific training and refresher training.

Requirements :

  • Undergraduate / Graduate in any stream with 2 to 4 years of experience in US Healthcare RCM for Account Receivable / Denial Management Resolution.
  • Fluent communication, both verbal and written.
  • Good analytical skills, attention to detail, and resolution-oriented.
  • Should have knowledge about the RCM end-to-end cycle and proficiency in AR fundamentals and denial management.
  • Basic knowledge of computers and MS Office.
  • Key Responsibilities for EVBV :

  • Review and verify patient insurance coverage, eligibility, and benefits prior to appointments or claim submission.
  • Conduct insurance verification through payer websites, IVR systems, or direct calls to insurance companies.
  • Accurately document insurance benefits, co-pays, deductibles, co-insurance, and coverage limitations in the practice management system.
  • Identify discrepancies or inactive policies and escalate or resolve them as appropriate.
  • Maintain up-to-date knowledge of insurance plans, benefit structures, and payer guidelines.
  • Ensure timely and accurate completion of verifications as per client SLA or daily targets.
  • Adhere to Standard Operating Procedures (SOPs) and compliance guidelines.
  • Escalate payer-related issues, trends, or delays to team leads or management.
  • Participate in client-specific training and continuous upskilling programs.
  • Requirements :

  • Undergraduate / Graduate in any stream with 1 to 3 years of experience in US Healthcare RCM, specifically in Eligibility & Benefits Verification.
  • Strong communication skills (verbal and written) with clarity and professionalism during payer calls.
  • Proficient in working with payer portals, IVR systems, and MS Office tools.
  • Basic understanding of insurance terminology (e.g., HMO, PPO, deductible, co-pay, out-of-network).
  • Ability to work under deadlines with strong attention to detail and accuracy.
  • Knowledge of the end-to-end RCM process and patient access cycle is preferred.
  • Key Responsibilities for Authorization :

  • Review patient and procedure details to determine if prior authorization is required based on payer policies.
  • Obtain authorizations by submitting complete and accurate information through payer portals, fax, or direct calls.
  • Understand and follow payer-specific authorization guidelines and timelines.
  • Track and follow up on pending authorization requests and escalate issues if needed.
  • Ensure timely documentation of authorization numbers, approval dates, and denial reasons in the practice management system.
  • Communicate with providers, patients, and internal teams regarding authorization status and requirements.
  • Respond to reauthorization requests or additional information required by payers.
  • Maintain compliance with HIPAA and payer-specific regulations.
  • Stay updated with changes in authorization requirements and payer-specific guidelines.
  • Meet daily / weekly targets for authorization submissions and follow-ups.
  • Participate actively in team meetings, training sessions, and process improvements.
  • Requirements :

  • Undergraduate / Graduate in any stream with 1 to 3 years of experience in US Healthcare RCM, specifically in Authorization Management.
  • Experience in submitting and managing authorization requests via insurance portals, fax, or telephonic communication.
  • Sound knowledge of payer-specific requirements for different specialties (e.g., radiology, DME, sleep studies, surgeries, etc.).
  • Excellent communication skills (both verbal and written), especially for handling payer calls.
  • Familiarity with documentation and record-keeping in EHR / EMR or RCM systems.
  • Basic proficiency in MS Office and navigating web-based payer platforms.
  • Create a job alert for this search

    Ar Caller • Mumbai, Maharashtra, India

    Related jobs
    • Promoted
    Senior Medical Billing Java

    Senior Medical Billing Java

    Anicalls (Pty) Ltdmumbai, India
    Experience in working with a Clearing House for submitting and receiving medical claims using EDI formatted files.Experience with claim generation and claim posting processes.Strong Knowledge of OO...Show moreLast updated: 30+ days ago
    • Promoted
    Duck Creek Billing Architect or Technical SME

    Duck Creek Billing Architect or Technical SME

    HTC Global ServicesThane, IN
    Connects- We are seeking an experienced.Duck Creek Billing solution in a P&C insurance environment.You will provide technical leadership, oversee solution architecture, work closely with business a...Show moreLast updated: 7 days ago
    • Promoted
    Unit Medical Services Head- Bangalore

    Unit Medical Services Head- Bangalore

    Manipal Hospitals (MHEPL)Kalyan-Dombivli, IN
    Provides clinical and administrative direction for the clinical operation of medical departments and services.Responsible for the co-ordination and oversight of all medical care and support clinica...Show moreLast updated: 16 days ago
    • Promoted
    Mechanical Engineer

    Mechanical Engineer

    MASH MakesKhopoli, Maharashtra, India
    Job Description : Mechanical Maintenance Engineer.Location : MASH Test Centre Khopoli.Candidate should besed on preferably based in Khopoli, Khalapur – as close to the factory as possible.Joining Bon...Show moreLast updated: 30+ days ago
    • Promoted
    AR Callers & Denial Management, EVBV, Authorization Specialists - (Medical Billing)

    AR Callers & Denial Management, EVBV, Authorization Specialists - (Medical Billing)

    RevUpside Business Solutions Private LimitedNavi Mumbai, Mumbai (district)
    Review account thoroughly, including any prior comments on the account, EOBs / ERAs / Correspondence, and perform pre-resolution analysis. Understand the reason for rejection, denials, or no status ...Show moreLast updated: 3 days ago
    • Promoted
    Lead Verification Tele caller

    Lead Verification Tele caller

    SingleDebtMumbai, Maharashtra, India
    We Are Hiring - Lead Verification Telecaller! 🚨 .Position : Telecaller for lead verification .Shift : Day Shift (9 AM - 6 : 30 PM) . Work Schedule : 6 days / week (1 Saturday off / month) .Company Descripti...Show moreLast updated: 30+ days ago
    • Promoted
    AR Callers & Denial Management, EVBV, Authorization Specialists – (Medical Billing)

    AR Callers & Denial Management, EVBV, Authorization Specialists – (Medical Billing)

    RevUpside Business Solutions Private LimitedNavi Mumbai, Maharashtra, India
    Review account thoroughly, including any prior comments on the account, EOBs / ERAs / Correspondence, and perform pre-resolution analysis. Understand the reason for rejection, denials, or no status ...Show moreLast updated: 30+ days ago
    • Promoted
    Oracle Cloud Financials Consultant

    Oracle Cloud Financials Consultant

    Absolute ApplicationsThane, IN
    Oracle Cloud Finance Consultant.Lead the implementation and support of Oracle Finance Cloud modules.Gather business requirements, analyze gaps, design solutions, configure systems, and map business...Show moreLast updated: 16 days ago
    • Promoted
    Billing Engineer

    Billing Engineer

    Aarvi EnconMumbai, Mumbai (district)
    Oil Gas,Refinery & Petrochemical experience).Mandatory : Notice period - Immediate joiner only.Interested Candidates may click to apply. Please note that the deadline to apply is 20th Oct 2025.Appli...Show moreLast updated: 3 days ago
    • Promoted
    Research And Development Associate

    Research And Development Associate

    MASH MakesKhopoli, Maharashtra, India
    Khopoli based or Vashi, Mumbai (Regular travel to Khopoli; occasional travel to Udupi).Write one line for each responsibility in a 1 page document, And make a ppt about MASH and send it to.MASH Mak...Show moreLast updated: 30+ days ago
    • Promoted
    Senior ar caller (mumbai)

    Senior ar caller (mumbai)

    AM Medical IT Solutions Pvt. Ltd.Mumbai, Maharashtra, India
    Job Title : AR / Sr AR Associate – AM Medical IT Solutions.Location : A002 UB, Boomerang Building, Oberoi Garden, Chandivali, Andheri East, Mumbai -. Experience : 6 months – 2 years | Shift : Night Shift...Show moreLast updated: 3 days ago
    • Promoted
    Oracle HCM Reporting Consultant

    Oracle HCM Reporting Consultant

    Absolute ApplicationsKalyan-Dombivli, IN
    Oracle HCM Reporting Consultant.Salary negotiable on experience.We are looking for an experienced Oracle HCM reporting Consultant. Oracle HCM focus in following : .Traditional HCM development skills : ...Show moreLast updated: 17 days ago
    • Promoted
    Resolution Analyst (Senior Tele-Collections Role)

    Resolution Analyst (Senior Tele-Collections Role)

    RezolutionThane, Maharashtra, India
    Resolution Analyst (Senior Tele-Collections Role) – Rezolution Performance Centre, Wagle Estate, Thane.LPA + incentives (up to 150%) –. A premium desk role for seasoned tele-collection specialists, ...Show moreLast updated: 16 days ago
    • Promoted
    Cost Accountant

    Cost Accountant

    The Sleep CompanyKalyan Dombivli, Maharashtra, India
    We are looking for a Cost Accountant (CMA) who has practical exposure to SAP S / 4HANA and master data management.The candidate will assist in cost planning and analysis activities, manage product ma...Show moreLast updated: 30+ days ago
    • Promoted
    Asst. / Associate Professor - AI&ML

    Asst. / Associate Professor - AI&ML

    Universal Ai UniversityKarjat, Maharashtra, India
    Universal Ai University, Karjat-Mumbai, is.India's first American Vice Chancellor with MIT (USA) pedigree.This is a full-time on-site role for an Assistant / Associate Professor - AI & ML, located in...Show moreLast updated: 30+ days ago
    • Promoted
    Senior Ar Caller (Mumbai)

    Senior Ar Caller (Mumbai)

    AM Medical IT Solutions Pvt. Ltd.Mumbai, India
    Job Title : AR / Sr AR Associate – AM Medical IT Solutions.Location : A002 UB, Boomerang Building, Oberoi Garden, Chandivali, Andheri East, Mumbai -. Experience : 6 months – 2 years | Shift : Night Shift...Show moreLast updated: 6 days ago
    • Promoted
    Customer Service Representative - International Voice Process

    Customer Service Representative - International Voice Process

    BROWNROOFThane, Maharashtra, India
    Customer Service Associate | US Healthcare Voice Support | Hiring Urgently.Job Role : Customer Service Associate.Process : International Inbound Voice Process. Salary : Up to ₹40,000 per month.Job Type...Show moreLast updated: 8 days ago
    • Promoted
    Assistant Manager - Purchase

    Assistant Manager - Purchase

    Soneji Engineering Pvt. Ltd.Virar, India
    Evaluate technical specifications and requirements of materials or components as per project or production needs.Identify and develop reliable suppliers and vendors based on quality, cost, and deli...Show moreLast updated: 5 days ago