AR Caller
As an AR Caller, you will be responsible for the timely and accurate resolution of claims, serving as the critical link between the client and the payer:
- Execute outbound calls to U.S. insurance companies (commercial, federal, state) to follow up on pending or denied medical claims.
- Analyze outstanding Accounts Receivable (A/R) reports and prioritize follow-up based on client Service Level Agreements (SLAs).
- Identify and interpret payer-specific requirements, denial codes, and complex claim resolution pathways.
- Take corrective action on claims delayed or denied due to coding, documentation, or patient data issues.
- Document all call outcomes, claim status updates, and action plans clearly and concisely in the client’s billing system.
- Collaborate with internal teams (e.g., Coding, Process Trainers) to secure necessary information or resolve claim clarifications.
- Escalate complex or high-value unresolved claims to the appropriate supervisory or payer level.
- Achieve daily and weekly productivity and quality targets consistently.
- Maintain the highest level of professionalism, integrity, and empathy during all interactions.
We are looking for individuals who are driven, articulate, and possess foundational RCM knowledge:
- Experience: 6 months to 3 years of progressive experience in AR Calling or U.S. Healthcare Revenue Cycle Management. (Exceptional Freshers with outstanding communication skills will also be considered).
- Education: Any graduate or diploma holder.
- RCM Expertise: Strong functional knowledge of claim denials, insurance follow-up processes, and U.S. healthcare terminology (e.g., CPT, ICD, allowed amounts).
- Communication: Excellent verbal communication skills with a clear, neutral accent, capable of professional interaction with U.S. payers.
- Analytical Ability: Proven analytical and problem-solving skills to efficiently interpret and resolve complex payer issues.
- Work Ethic: Adaptability and resilience to thrive in a fast-paced environment while consistently meeting rigorous performance and quality metrics.
- Technical Proficiency: Basic computer skills; familiarity with leading billing platforms (e.g., eClinicalWorks, Kareo, Athena, AdvancedMD) is highly advantageous.
| Competency | Description |
|---|---|
| Attention to Detail | Ensuring accurate documentation and claim analysis. |
| Active Listening | Understanding payer responses and internal team needs. |
| Accountability | Taking ownership of A/R resolution and performance. |
| Team Collaboration | Contributing positively to a shared success environment. |
| Adaptability | Managing fluctuating workloads and changing payer rules. |
- Shift Timings: Night Shift (Aligned with U.S. business hours).
- Work Schedule: Weekends off (schedule may vary slightly based on client requirements).