AR Caller VOICE

The AR Caller is responsible for actively managing and resolving outstanding accounts receivable for healthcare providers. This role involves extensive communication with insurance companies to ensure timely and accurate payment of medical claims. The ideal candidate will possess a strong understanding of the medical billing cycle, insurance policies, and denial management.

Worked in CMS1500 & UB04.
End to end Denials & Rcm.

Key Responsibilities:

• Initiate outbound calls to various insurance companies (commercial, Medicare, Medicaid, workers' compensation) to follow up on unpaid or underpaid claims.
• Investigate and identify the root causes of claim denials, rejections, and underpayments.
• Effectively communicate with insurance representatives to appeal denied claims, provide necessary documentation, and resolve payment discrepancies.
• Document all communication, actions taken, and resolutions accurately and thoroughly in the billing system.
• Analyze Explanation of Benefits (EOBs), Remittance Advices (RAs), and other payer correspondence to reconcile accounts.
• Collaborate with internal billing, coding, and credentialing teams to gather information and resolve complex billing issues.
• Maintain up-to-date knowledge of payer-specific billing guidelines, policies, and regulations.
• Adhere strictly to HIPAA guidelines and all other relevant compliance regulations.
• Prioritize and manage a high volume of accounts to meet daily, weekly, and monthly productivity and collection targets.
• Identify and escalate problematic accounts or trends to management for further review and resolution.
• Assist in identifying process improvements to enhance efficiency and reduce AR days.