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Senior AR Caller

2 months ago

Hyderabad, Telangana, India Happiehire Full time

Job Overview

We are seeking a skilled Senior AR Caller for our US Healthcare team, responsible for managing accounts receivable follow-up activities. This full-time opportunity requires a minimum of 1 year of experience in the field and expertise in Hospital billing, denial management, and AR follow-up to ensure efficient processing and payment resolutions.

Key Skills and Qualifications

  • Medical Billing and Coding Expertise: Proven experience in medical billing and coding is mandatory for this role, essential for handling complex claim issues effectively.
  • Denial Management: Ability to manage denial management with a keen understanding of payer policies and identification of denial trends (Mandatory skill).
  • AR Follow-up Processes: Proficient in AR follow-up processes, necessary for timely resolution of outstanding accounts and maintaining cash flow (Mandatory skill).
  • Insurance Verification: Experience with insurance verification, crucial for verifying patient information and coverage with third-party payers.
  • Payment Posting Procedures: Familiarity with payment posting procedures, ensuring accuracy in recording and applying payments.
  • Appeals Process: Strong knowledge of appeals process, adept at handling claim disputes and securing favorable outcomes for denied claims.
  • CPT/ICD-10 Codes: Understanding of CPT/ICD-10 codes, vital for accurate billing and coding of healthcare services rendered.
  • HIPAA Regulations: Comprehensive knowledge of HIPAA regulations to ensure compliance and protection of patient information.
  • UB-04 Claim Form: Knowledge of claim form UB-04.

Roles and Responsibilities

  • Conduct comprehensive accounts receivable follow-up for outstanding medical claims with insurance companies.
  • Identify and rectify any discrepancies or unpaid balances through denial management and appeals process.
  • Verify insurance policies to ensure patients have appropriate coverage for rendered services.
  • Post payments accurately in the billing system and reconcile any differences in payment received with expected amounts.
  • Collaborate with healthcare providers to clarify information on patient records and billing statements.
  • Maintain up-to-date knowledge on industry changes and insurers' policies to optimize accounts receivable collections.
  • Contribute to process improvements within the AR follow-up operations to enhance efficiency and effectiveness.
  • Ensure compliance with healthcare regulations, including HIPAA, to safeguard patient information throughout the billing process.