Follow-up & Collections:
Calling insurance companies (payers) and sometimes patients for outstanding balances and pending claims.
Denial Management:
Investigating denied or rejected claims, identifying root causes (e.g., eligibility, medical necessity, coding), and taking corrective action.
Appeals & Re-submissions:
Filing appeals and re-submitting corrected claims to get them paid.
Account Resolution:
Taking claims through to final resolution, ensuring maximum reimbursement.
Documentation:
Accurately logging all calls, actions, and claim updates in billing software.
Reporting:
Generating AR reports to track claim status, denial trends, and overall AR performance.
Collaboration:
Working with coders, billers, and other departments to fix systemic issues.

Preferred candidate profile

AR Calling

& Denial Management:
Hands-on experience with the entire lifecycle of a denied claim.
US Healthcare:
Expertise in physician or hospital billing, understanding payer rules (Medicare, Medicaid, Commercial).
Revenue Cycle Management

(RCM):
Broad understanding of the billing process, not just calling.
Denial Resolution:
Handling appeals, rejections, refiling, and resubmissions.
Proactive Action:
Identifying root causes (e.g., eligibility errors, lack of authorization, timely filing) and correcting them.
Specific Skills:
Eligibility Verification, Authorization, Claims Processing

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