Ar Caller ( UBO4)

HOSPITAL AR -UB-04 Specialist

Job Summary

The AR Caller UB-04 Specialist is responsible for managing and following up on outstanding hospital and facility claims submitted on UB-04 (CMS-1450) forms. This role involves calling insurance companies, verifying claim status, identifying denials, and ensuring timely reimbursement. The ideal candidate should have strong knowledge of hospital billing procedures, payer guidelines, and claims adjudication processes, along with excellent communication skills for interacting with payers.

Key Responsibilities

Make outbound calls to insurance companies to check the status of submitted UB-04 claims.

Resolve pending, denied, or underpaid claims by following up with payers promptly.

Document payer responses and next steps in billing software accurately.

Review and understand hospital/facility claims submitted on UB-04 forms, including revenue codes, bill types, occurrence codes, value codes, and condition codes.

Verify correct claim submission, billing codes, and modifiers as per payer requirements.

Escalate unresolved or complex claims to senior AR staff or team leads.

Identify patterns in denials and take corrective actions.

Coordinate with coding and billing teams to correct and resubmit claims when necessary.

Work on payer-specific denial reasons (e.g., Medicare, Medicaid, Commercial payers).

Understand the difference between UB-04 (facility) and CMS-1500 (professional) claim forms.

Ensure claims comply with payer rules, NUBC guidelines, and billing regulations.

Support claim submission processes and suggest improvements to reduce AR days.

Maintain clear and accurate notes of follow-up actions in the billing system.

Meet daily/weekly productivity and quality targets for calls and resolved claims.

Provide feedback to the billing team regarding claim issues, payer trends, or process gaps.

Required Skills & Qualifications

Minimum 23 years of experience in AR calling with a focus on UB-04 hospital/facility billing.

Strong knowledge of medical billing, insurance claims lifecycle, and denial management.

Familiarity with Medicare, Medicaid, and commercial payer guidelines.

Hands-on experience with billing software / EMR / practice management systems.

Excellent communication skills (verbal & written) for payer interaction.

Strong analytical and problem-solving skills with attention to detail.

Ability to work independently and as part of a team in a deadline-driven environment.

Preferred Qualifications

Experience in both inpatient and outpatient facility billing.

Knowledge of HIPAA regulations and patient data confidentiality.

Understanding of RARC and CARC codes, claim adjustment reason codes, and remittance advice.

Prior exposure to payer portals and clearinghouses for claim tracking.

Key Performance Indicators (KPIs)

Average number of claims followed up per day

AR reduction and Days in AR improvement

Denial resolution turnaround time

First call resolution percentage

Accuracy and quality of call documentation

Experience 2-3 Yrs

Location (Coimbatore)

Work Timing 6:30Pm 3:30AM

Working Days 5 Days( Mon Fri)

Notice Period Looking for Immediate Joiner

Budget 35K Take Home