AR Collections

Job Title

AR Caller (Accounts Receivable – US Healthcare)

Location

Pranava Group, beside Harsha toyota showroom, Kothaguda, Telangana 500084| Shift: US Shift (Night) | Employment: Full-time

About the Role

As an AR Caller, you will follow up with US insurance payers and patients to resolve unpaid/denied medical claims, accelerate collections, and reduce days in A/R. You’ll work closely with billing/coding teams to ensure timely, accurate reimbursement.

Key Responsibilities

• Place outbound calls to insurance companies and patients to follow up on unpaid/underpaid/denied claims.
• Review EOBs/ERAs, payer portals, and practice management systems to identify issues and next actions.
• Analyze denials (CO/PR codes), determine root causes, and initiate corrective steps (appeals, resubmissions, coding fixes).
• Document call outcomes and next actions in the billing system with accurate notes and dispositions.
• Escalate complex cases (medical necessity, coding discrepancies, timely filing risk) to billing/coding teams.
• Track and work aging buckets (0–30, 31–60, 61–90, 90+ days) to reduce AR and improve cash flow.
• Adhere to payer-specific guidelines, TATs, and timely filing limits.
• Maintain HIPAA compliance and patient data confidentiality.
• Meet or exceed daily/weekly productivity and quality targets.

Required Qualifications

• 1–3 years of US healthcare AR calling / RCM experience (physician or hospital billing).
• Strong understanding of the claims lifecycle, CPT/ICD modifiers at a working level, denial codes, EOB/ERA reading.
• Excellent spoken English and call handling skills; confident on outbound payer calls.
• Proficiency with billing/PM systems (e.g., Kareo, Athena, eClinicalWorks, AdvancedMD, NextGen, or similar) and MS Excel.
• Ability to work US time zones and meet aggressive SLAs.

Preferred (Nice to Have)

• Experience with payer portals (UHC, Aetna, Medicare, Medicaid, BCBS, etc.).
• Knowledge of appeals writing and reconsideration processes.
• Exposure to specialties (e.g., Radiology, Anesthesia, DME, PT/OT, Behavioral Health).
• Certified Professional Coder (CPC-A/CPC) or RCM certifications (preferred, not mandatory).

Key Skills

• Denial management & AR follow-up
• Problem solving & negotiation
• Attention to detail & documentation
• Time management & prioritization
• Customer focus and professionalism
• HIPAA compliance awareness

Performance Metrics (KPIs)

• Calls per day / Right Party Contacts (RPC)
• Promise-to-pay kept rate & $ collected
• AR days reduction & % AR >90 reduced
• Denial overturn rate / Appeal success rate
• First-call resolution & QA score

Job Types: Full-time, Permanent, Fresher

Pay: ₹350,000.00 - ₹450,000.00 per year

Benefits:

• Health insurance
• Provident Fund

Work Location: In person