Job Specification - Designation: AR Caller - Experience: 1 - 2 Years - Education Qualification: Graduate in any stream - Location : Preference to the candidates in and around Thrissur, Ernakulam Job Description: - Excellent verbal and written communication skills in English (Mandatory) - Good Analytical and problem-solving skills - Basic computer knowledge is essential - Basic knowledge in MS Office application is essential - Good keyboarding skills - Ability to learn and adapt to a fast-paced work culture. - Working days: 5 days (Off on Saturday & Sunday) - Shift schedule: Night shift only Required Experience Minimum 1 year of hands-on experience in Medical Billing and Claims with demonstrated expertise in all of the areas below: Behavioural Health Billing Candidates should have hands-on experience preparing and submitting claims related to behavioural health services. This includes familiarity with both CMS-1500 (professional claims) and UB-04 (institutional claims) forms. Laboratory Billing Strong knowledge of laboratory billing procedures, with direct experience in processing and submitting UB-04 claim forms for laboratory services. Payer Experience Applicants must demonstrate a working knowledge of billing and reimbursement processes for Commercial Insurance Companies. Medicare Medicaid Candidates should be comfortable navigating the complexities of payer-specific guidelines, resolving claim denials, and ensuring timely follow-up for optimal reimbursement.

Designation: SME - Denial Management Experience: 2-3 years Skills desired: Detailed knowledge of US healthcare billing cycle Experience working with different EMR/EHR systems like Epic, Cerner, Allscripts, Athenahealth, NextGen, eClinicalWorks, Meditech, etc. Denial analysis and management - Review and analyze denied insurance claims to identify cause of denials such as coding issues, preauthorization, payer-specific policies - Develop and track denial log to monitor patterns and trends in denied claims - Experience talking with payers to obtain clarification with denials and initiate timely appeals when appropriate Expertise in working with denial reason codes (CARC, RARC) and identifying root causes of denials. Strong understanding of billing regulations, CPT, ICD-10, HCPCS codes, and compliance standards (HIPAA, CMS guidelines). Appeals - - Understand 1st, 2nd, 3rd, and External Level Appeal process, system, and documentation SOP - Prepare, submit, and follow up on appeals ensuring all necessary documentation is included - Revie Review assigned denials and EOBs for appeal filing information. Gather any missing information - Review case history, payer history, and state requirements to determine appeal strategy - Obtain patient and/or physician consent and medical records when required by the insurance plan or state - Gather and fill out all special appeal or review forms - Create appeal letters, attach the materials referenced in the letter, and mail them Maintain a record of all appeals and responses to track appeal outcomes and recovery rates Monitor payer response timelines to ensure appeal filing deadlines are met Track insurance company and state requirements and denial trend changes

Designation: SME - Denial Management Experience: 2-3 years Skills desired: • Detailed knowledge of US healthcare billing cycle • Experience working with different EMR/EHR systems like Epic, Cerner, Allscripts, Athenahealth, NextGen, eClinicalWorks, Meditech, etc. • Denial analysis and management Review and analyze denied insurance claims to identify cause of denials such as coding issues, preauthorization, payer-specific policies Develop and track denial log to monitor patterns and trends in denied claims Experience talking with payers to obtain clarification with denials and initiate timely appeals when appropriate Expertise in working with denial reason codes (CARC, RARC) and identifying root causes of denials. Strong understanding of billing regulations, CPT, ICD-10, HCPCS codes, and compliance standards (HIPAA, CMS guidelines). • Appeals Understand 1st, 2nd, 3rd, and External Level Appeal process, system, and documentation SOP Prepare, submit, and follow up on appeals ensuring all necessary documentation is included - Revie Review assigned denials and EOB’s for appeal filing information. Gather any missing information - Review case history, payer history, and state requirements to determine appeal strategy - Obtain patient and/or physician consent and medical records when required by the insurance plan or state - Gather and fill out all special appeal or review forms - Create appeal letters, attach the materials referenced in the letter, and mail them Maintain a record of all appeals and responses to track appeal outcomes and recovery rates Monitor payer response timelines to ensure appeal filing deadlines are met Track insurance company and state requirements and denial trend changes Job Types: Full-time, Permanent Benefits: Leave encashment Provident Fund Schedule: Rotational shift Experience: Denial Management: 2 years (Preferred) Work Location: In person Application Deadline: 10/08/2025