Senior Associate

Job Description

Please note - This Profile is not into Finance Sector. Job Title : AR Caller / Credentialing Specialist Location : Pune, Navi - Mumbai and Nagpur (Work from Office) Company Profile : First Insight is a software product development and revenue cycle management company based in Portland, Oregon (USA). It has its India development and service delivery centre in Pune, Mumbai and Nagpur. Its expertise and domain lies in healthcare and insurance. Its a forward thinking, visionary company that provides high quality software solutions, services, support and training to nearly a thousand optometric and ophthalmic practices in the United States .It has carved a niche in the healthcare industry with its practice management and electronic health records software, support, e-commerce solutions and revenue cycle management services. To know more about First Insight, please visit @ www.first-insight.com . We are hiring AR Callers for our facility in Pune, Mumbai and Nagpur. The AR callers have to work from office upon joining. The details are as under: Job Description: • Reduce AR aging of clients and increase their cash flow. Ensure that AR aging always meets industry standards. • Review and analyze unpaid or denied insurance claims. Contact insurance companies to follow up on outstanding claims, determine the reason for non-payment, and resolve any issues leading to delays or denials. • Constantly keep track of both electronic and paper claims. • Identify claims that have been denied and prepare necessary documentation for appeals. Resubmit corrected claims with accurate information and supporting documents as required by the insurance company. • Investigate and resolve discrepancies in billing records, such as incorrect coding, missing information, or duplicate charges. Coordinate with internal departments to ensure accurate billing practices. • Maintain detailed and organized records of all communication, interactions, and follow-up actions taken with insurance companies, and other relevant parties. • Analyze reasons for claim denials and work with billing and coding teams to address underlying issues. Implement strategies to minimize future claim denials. • Verify patient insurance coverage and eligibility, ensuring accurate and up-to-date information is available for claims submission. In case the patient does not have sufficient insurance coverage for the medical procedure or if the patient is in any way not eligible for coverage, transferring the outstanding balance to the patient. Monitor aging reports to identify and prioritize accounts that require immediate attention. Take proactive measures to expedite payment collection on aging accounts. • Collaborate with colleagues in billing, coding, and revenue cycle departments to ensure seamless communication and resolution of payment related issues. • Adhere to HIPAA regulations and industry standards to maintain patient confidentiality and ensure compliant billing practices. Qualifying Criteria: • Strong knowledge of medical billing and insurance procedures, including CPT and ICD-10 codes. • At least 1+ year of experience in AR Calling in an Accounts Receivable process in US Healthcare (End to End RCM Process) • Ability to multi-task • Good organization skills demonstrating the ability to execute timely follow-ups • Willingness to be a team player and show initiative where needed • Ready to work in night shifts • Excellent oral and written communication skills Salary: Remuneration will be at par with the best industry standards; will not be a constraint for the right candidate. Kindly Note - RCM (Revenue cycle management) Knowledge is mandatory. Interested Candidate can directly call / Share there resume with H.R - Shubham More - 8369218615