AR Caller

AR CALLER

• After patient transactions have been properly coded, create billing batches
• Review information from the patient’s file on system chart
• Verify insurance coverage
• Bill per procedure and appropriate contract
• Verify procedures and check modifiers
• Calculate correct fee and process billing transactions
• Demonstrates general knowledge of billing practices and maintains departmental standards relating to insurance claims processing, charge entry and billing functions
• This role is also responsible for providing support to other departments within the SHA related to billing functions, including communicating claim issues to departmental management for further discussion with payor representatives and other key stakeholders as needed and as applicable
• Provides support for the revenue cycle departments (as applicable: payment posting, coding and accounts receivable (AR) follow up) related to administrative duties as needed
• Assists with knowledge sharing, payor and department training, and provides support to other team members as advised by the manager and/or supervisor
• Train new employees in billing, posting and AR
• Resolves routine insurance billing inquiries and problems within departmental standards
• Follows established departmental workflows within the electronic health record system appropriate work queues in response to correspondence/reports/data/requests received
• Processes financial/insurance correspondence received associated to billing functions
• Meets departmental productivity and quality standards
• Completes claim edits timely, compliantly, and without errors
• Documents clear, concise and complete notes in system for each account worked
• Identifies claim processing issues and general billing trends
• Notifies supervisor and/or manager regarding trends to avoid further delay in claims processing
• Demonstrates understanding of fundamentals of all payers, including Medicare, Medicaid and commercial payers, and applicable revenue cycle operations
• Maintains strict confidentiality of patients, employees and hospital information always
• Ensures protection of private health and personal information
• Adheres to all Health Insurance Portability and Accountability Act (HIPAA)
• Ensures claims are submitted within payor deadlines and reports barriers to claim submission to management
• Work on daily, weekly and monthly report as per client and business needs
• Completes billing functions within established departmental standards including billing related work queues and workflows to ensure claims are billed accurately, compliantly, and timely
• Resolves basic edits, rejections, and unresolved/no response insurance claims
• Processes actions to resolve clearinghouse billing, rejections, and eligibility related errors to ensure timeliness of charge/claim submission
• Monitors and processes all ‘no response’ claims for timely resolution of services within established work queues
• Complete AR follow up processes, including claim corrections, appeals, payor follow up and resubmissions to expedite reimbursement relation to coding or other payor-based denials.
• Analyze individual payor performances regarding fee schedule reimbursements and trends.
• Where applicable, submits accurate adjustments based on billing guidelines and departmental policies, contract requirements, or levels of authority
• Remains current on billing guidelines and regulations of various payers and/or specialty practices as directed by the supervisor and/or manager
• Ensures to achieve the below target with quality of 97% and above:
• Billing – 200 DOS / day
• Posting – 500-line item/ day
• Rejection or Denial – 70 per day
• AR calling – 45 Per day
• Other duties as assigned

Freshers with Excellent communication skills can apply.

Job Types: Full-time, Permanent, Fresher

Pay: ₹15,000.00 - ₹30,000.00 per month

Benefits:

• Provident Fund

Application Question(s):

• How many years of experience do you have in AR Calling?
• What is your current salary package ?
• Are you an immediate joiner? Please mention your notice period?

Work Location: In person