US Healthcare

Key Responsibilities:

• Handle inbound and outbound calls to/from insurance companies and patients in the US.
• Work on various aspects of RCM like eligibility verification, claim status inquiry, prior authorization, and denial management.
• Accurately document call details and update patient or claim records in internal systems.
• Follow HIPAA compliance and maintain the confidentiality of patient information.
• Coordinate with internal teams to resolve issues related to claims or billing.
• Meet KPIs including AHT (Average Handling Time), FCR (First Call Resolution), and Quality Scores.
• Stay updated with US healthcare guidelines, insurance terminologies, and payer policies.

Requirements:

• Education: Any graduate (life sciences or healthcare background preferred).
• Experience: 6 months to 2 years in US healthcare voice process (AR Calling, Claims Processing, etc.). Freshers with excellent communication skills can apply.
• Excellent verbal communication skills in English (neutral or US accent preferred).
• Knowledge of medical billing terminologies, ICD/CPT codes, or EOBs is a plus.
• Comfortable working night shifts and in a performance-driven environment.
• Strong problem-solving and data entry skills.