Ar Collections

4 days ago

Hyderabad Telangana, India TriaRight Solutions LLP Full time

Job Title AR Caller (Accounts Receivable - US Healthcare) Location Pranava Group, beside Harsha toyota showroom, Kothaguda, Telangana 500084| Shift: US Shift (Night) | Employment: Full-time About the Role As an AR Caller, you will follow up with US insurance payers and patients to resolve unpaid/denied medical claims, accelerate collections, and reduce days in A/R. You’ll work closely with billing/coding teams to ensure timely, accurate reimbursement. Key Responsibilities - Place outbound calls to insurance companies and patients to follow up on unpaid/underpaid/denied claims. - Review EOBs/ERAs, payer portals, and practice management systems to identify issues and next actions. - Analyze denials (CO/PR codes), determine root causes, and initiate corrective steps (appeals, resubmissions, coding fixes). - Document call outcomes and next actions in the billing system with accurate notes and dispositions. - Escalate complex cases (medical necessity, coding discrepancies, timely filing risk) to billing/coding teams. - Track and work aging buckets (0-30, 31-60, 61-90, 90+ days) to reduce AR and improve cash flow. - Adhere to payer-specific guidelines, TATs, and timely filing limits. - Maintain HIPAA compliance and patient data confidentiality. - Meet or exceed daily/weekly productivity and quality targets. Required Qualifications - 1-3 years of US healthcare AR calling / RCM experience (physician or hospital billing). - Strong understanding of the claims lifecycle, CPT/ICD modifiers at a working level, denial codes, EOB/ERA reading. - Excellent spoken English and call handling skills; confident on outbound payer calls. - Proficiency with billing/PM systems (e.g., Kareo, Athena, eClinicalWorks, AdvancedMD, NextGen, or similar) and MS Excel. - Ability to work US time zones and meet aggressive SLAs. Preferred (Nice to Have) - Experience with payer portals (UHC, Aetna, Medicare, Medicaid, BCBS, etc.). - Knowledge of appeals writing and reconsideration processes. - Exposure to specialties (e.g., Radiology, Anesthesia, DME, PT/OT, Behavioral Health). - Certified Professional Coder (CPC-A/CPC) or RCM certifications (preferred, not mandatory). Key Skills - Denial management & AR follow-up - Problem solving & negotiation - Attention to detail & documentation - Time management & prioritization - Customer focus and professionalism - HIPAA compliance awareness Performance Metrics (KPIs) - Calls per day / Right Party Contacts (RPC) - Promise-to-pay kept rate & $ collected - AR days reduction & % AR >90 reduced - Denial overturn rate / Appeal success rate - First-call resolution & QA score **Job Types**: Full-time, Permanent, Fresher Pay: ₹350,000.00 - ₹450,000.00 per year **Benefits**: - Health insurance - Provident Fund Work Location: In person

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