Job Title: US Healthcare AR Caller
Location: Navi Mumbai Turbhe
About the Role
We are seeking dedicated and experienced Accounts Receivable (AR) Callers to join our Revenue Cycle Management (RCM) team in Navi Mumbai. This role is critical to ensuring timely reimbursement by managing and resolving outstanding insurance claims within the US Healthcare system. The ideal candidate will possess strong knowledge of US healthcare billing processes, hands-on experience with Epic software, and a solid understanding of compliance and payer guidelines.
Key Responsibilities
- Claim Follow-Up & Resolution:
- Proactively contact US-based insurance payers via phone to follow up on outstanding medical claims and ensure prompt payment.
- Form Preparation & Submission:
- Accurately prepare and submit claim forms in compliance with CMS-1500, UB-04, CMS guidelines, and third-party payer requirements.
- Denial Management:
- Analyze, manage, and resolve claim denials using comprehensive end-to-end denial management knowledge within the US healthcare framework.
- Compliance & Documentation:
- Ensure all activities comply with US healthcare regulations, including HIPAA, and maintain accurate documentation of payer communications and follow-up actions in the billing system.
- Service Excellence:
- Maintain a high level of professionalism while interacting with internal teams, clients, and US-based payer representatives.
Required Qualifications & Skills
Experience
- 12 years of proven experience as an AR Caller in the US Healthcare industry.
- Mandatory hands-on experience with Epic Software.
- Experience working with CMS-1500 claims and US EOBs (Explanation of Benefits).
Education
Skills & Knowledge
- Strong end-to-end knowledge of US healthcare denial management processes.
- Familiarity with US medical billing codes and payer guidelines.
- Excellent verbal communication, analytical, and problem-solving skills.
- Professional command of spoken and written English
