AR Caller Settling Claims and Obtaining Income

AR Caller Settling Claims and Obtaining Income Job Description The main "Revenue Recovery Anchor" and "Claim Cash Flow Guardian" for our healthcare billing operations is the AR Caller/-Medical Billing & Revenue Cycle Management /(Accounts Receivable Specialist, Claim Denial Resolution & Insurance Follow/-Up Specialist/). Your main responsibility is to actively follow up with US commercial and government insurance payers /(such as Medicare, Medicaid, Blue Cross Blue Shield, UnitedHealthcare, Aetna, and Cigna/) to resolve unpaid, rejected, or denied medical claims, while medical coders translate clinical charts into standard codes and billing specialists submit initial claims. This includes using payer web portals, speaking with insurance agents directly over the phone, examining Explanation of Benefits /(EOB/) and Electronic Remittance Advices /(ERAs/), challenging incorrect claim denials, and obtaining timely compensation for medical professionals. Key Duties Insurance Follow/-Up & Outstanding Claim Resolution/: To find out the status of outstanding, outdated, or unpaid medical claims, make daily outbound calls and check the web portal with commercial and government insurance payers. Management of Denials and Claims Appeals/: Examine denial codes, underpaid line items, and claim rejections; write formal appeal letters with accompanying medical records to reverse incorrect payer rejections. EOB/ERA Analysis & Rejection Troubleshooting/: Examine Electronic Remittance Advice and Explanation of Benefits to confirm accurate payment amounts, contractual write/-offs, copays, deductibles, and co/-insurance allocations. Rebilling and Correction of Claims/: Find coding mistakes, missing modifiers, inaccurate patient demographics, or out/-of/-date insurance eligibility information; fix and resubmit clean claims to payers via paper or electronic clearinghouses. We invite you to apply and explore this exciting opportunity/! Warm Regards, HR /- Maria