AR Calling - RCM 

Job Description: 

• Responsible for calling Insurance companies (in US) on behalf of doctors/physicians and follow up on outstanding Accounts Receivable. 
• To prioritize the pending/overdue tasks for calling/working from the aging basket. 
• Should be able to convince the claims company (payers) for reprocessing the claims for payment of their outstanding claims. 
• To check the appropriateness of the demographic/insurance information given by the patient if it is inadequate or unclear. 
• To make a physical call by following the international norms and applicable rules for confidentiality and HIPAA compliance. 
• Escalate difficult collection situations to the team’s supervisors in a timely manner. 
• Review provider claims that have not been paid by insurance companies or denied by the insurance companies. 
• Handling patients billing queries and updating their account information. 
• Working on denied claims by taking the appropriate action 
• Routing denials to the correct department in case of fix the hole opportunities 
• Escalate all avoidable denials to the team’s supervisors where there is a direct revenue loss for the practice and the company  
• Sharing new findings with the team’s supervisors and the team 
• Post cash and write off the contractual adjustments accordingly while working on the accounts. 
• Meeting daily/weekly and monthly targets set for an individual. 

Desired Profile: 

• Should be willing to work in US Shift. 
• Experience in Denial Management (Healthcare Revenue Cycle Management) process. 
• Strong written and verbal communication skills. 
• Good computer skills including Microsoft Office suite. 
• Ability to prioritize and manage work queue. 
• Ability to work independently as well as in a team environment. 
• Should be a result oriented person and works towards solving the issues instead of dragging the issues. 
• Strong analytical and problem-solving skills. 
• Good typing skills with a speed of min 30-35 words /min.