AR Caller (Healthcare)

Job Description: US Healthcare AR Callers

Location: Navi Mumbai, Turbhe

About the Role

We are seeking dedicated and experienced Accounts Receivable (AR) Callers to join our Navi Mumbai team. This crucial role within our Revenue Cycle Management (RCM) operations focuses specifically on managing and resolving outstanding claims within the US healthcare sector. The ideal candidate will be proficient in specific medical billing software, demonstrate expert knowledge of US healthcare guidelines, and maintain strict compliance with industry standards.

Key Responsibilities

· Claim Follow-Up and Resolution: Proactively follow up with US-based medical insurance payers via phone regarding the status of outstanding claims to ensure timely reimbursement.

· Form Preparation & Submission: Accurately complete and send appropriate claim forms, adhering strictly to US CMS, UB04, CMS-1500, and third-party payer guidelines.

· Denial Management: Utilize end-to-end process knowledge to manage, analyze, and resolve claim denials efficiently within the US healthcare framework.

· Compliance and Documentation: Ensure all activities align with US healthcare regulations (e.g., HIPAA) and maintain meticulous documentation of all follow-up actions and communications within the billing system.

· Service Excellence: Demonstrate a high level of professionalism and service excellence when interacting with all clients, employees, and US-based patient account details.

Required Qualifications & Skills

· Experience:

o 1 to 2 years of proven experience in an AR calling role exclusively within the US Healthcare Industry.

o Specific, hands-on experience working with Epic Software is mandatory.

o Experience working with the CMS-1500 process and US EOBs (Explanation of Benefits).

· Eligibility:

o Any Graduate degree is acceptable.

· Skills & Knowledge:

o In-depth, end-to-end process knowledge of Denial Management relevant to US payers.

o Familiarity with US billing codes and guidelines.

o Strong communication and problem-solving skills with a professional command of English.

Skills Required
Denial Management