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AR Callers, Prior Auth, EVBV Process
ConfidentialMumbai, Chennai, Hyderabad / Secunderabad, Telangana2 days ago
Job descriptionGood spoken English (US accent preferred). Understanding of US healthcare terms and insurance types (Medicare, Medicaid, commercial). Experience in AR calling / denial management preferred (freshers can be trained). Strong attention to detail and time management skills. Initiate and obtain prior authorizations from insurance carriers for procedures, medications, or services. Review patient eligibility and benefits through insurance portals and calls. Ensure all documentation and clinical notes are submitted accurately for approval. Communicate with healthcare providers and insurance reps to track authorization status. Maintain authorization logs and escalate pending requests before scheduled services. Handle both pre-certification and retro-authorization workflows depending on the specialty. Excellent communication (written and verbal) and coordination skills. Basic understanding of insurance verification and medical necessity requirements. Familiarity with EHR systems like Epic, Cerner, or Athena is a plus. Prior experience in prior auth / eligibility verification is preferred but not mandatory.
Key Responsibilities :
- Contact insurance companies (via outbound calls) to follow up on unpaid or denied claims .
- Review and analyze EOBs (Explanation of Benefits) and identify reasons for denials or delays.
- Take corrective actions—resubmissions, appeals, or adjustments—based on payer responses.
- Update billing software with clear notes on call outcomes and claim status.
- Meet daily productivity and quality benchmarks.
- Follow HIPAA guidelines and maintain compliance at all times.
Requirements :
2. Role : Prior Authorization Executive
Key Responsibilities :
Requirements :
Skills Required
Documentation, Ar Calling, Denial Management
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Ar Caller • Mumbai, Chennai, Hyderabad / Secunderabad, Telangana