About the role
Summary
An AR Caller is responsible for following up on unpaid or denied medical insurance claims with US insurance companies to ensure timely reimbursement for healthcare providers. The role involves analyzing claim status, resolving denials, identifying payment issues, and reducing accounts receivable aging.
What you'll do
- Call US insurance companies to obtain claim status and payment information.
- Follow up on outstanding accounts receivable and pending claims.
- Investigate denied, rejected, or underpaid claims.
- Review Explanation of Benefits (EOB) and Electronic Remittance Advice (ERA).
- Document call outcomes and actions taken in billing systems.
- Resubmit corrected claims when required.
- Escalate unresolved issues to supervisors or clients.
- Work on aging reports to reduce outstanding balances.
- Meet productivity, quality, and collection targets.
- Ensure compliance with HIPAA and client guidelines.
What you have
- Any Graduate (preferred)
- Good Communication
Key Performance Indicators
- Number of claims worked per day.
- Calls completed per day.
- Collection amount recovered.
- Reduction in AR aging.
- Denial resolution rate.
- Quality and compliance scores.
Experience
- 3+ Years of Experience
- Calling of Workers Comp claims and Refunds
- Experience in NextGen is preferred