SME- AR Calling

The SME provides deep expertise in medical billing, insurance follow-ups, and claim resolutions, ensuring efficient cash flow and reducing outstanding AR days.

They serve as a key resource for process improvements, training, and escalations related to claim denials, appeals, and payment discrepancies.

Prior experience in Emergency Medical Services (EMS) will be add on advantage

Essential Skills :

Strong knowledge of US healthcare AR, insurance billing, and payer guidelines.

Excellent analytical, problem-solving, and communication skills.

Experience in working with aging reports, denials, and appeals processing.

Key Responsibilities :

Monitor and manage the AR process, including claim submissions, follow-ups, and appeals.

Ensure timely follow-up on unpaid claims, denials, and appeals with insurance companies.

Analyze aging reports and take necessary actions to reduce outstanding receivables.

Analyze and categorize denials to identify trends and root causes.

Work with clients and insurance providers to resolve recurring denial issues.

Act as a point of contact for clients, insurance providers, and internal stakeholders.

Provide regular reports on AR performance, collections, and outstanding receivables.

Key Measurable :

AR Aging Reduction

Denial Resolution Rate

Escalation Resolution Rate