01Overview
Job Summary
We are looking for an experienced AR Caller with 23 years of experience in US
Healthcare Medical Billing, preferably with strong hands-on experience in
eClinicalWorks (eCW). The candidate will be responsible for following up on
outstanding insurance claims, identifying and resolving denials, contacting insurance
companies, working on aging AR, and ensuring timely claim resolution and payment.
The ideal candidate should have strong knowledge of US insurance processes, claim
status, denials, appeals, eligibility, EOB/ERA interpretation, CPT/ICD-10 basics,
modifiers, and payer portals.
Key Responsibilities
1. AR Follow-Up
2. Denial Management
Analyze insurance denials and identify the root cause.
Work on denials related to:
o Eligibility and coverage
o Authorization/referral
o Medical necessity
o Coding
o Modifier issues
o Bundling
o Duplicate claims
o Timely filing
o Provider enrollment
o Incorrect provider information
o Non-covered services
o Claim submission errors
o Coordination of Benefits (COB)
o Patient responsibility
Correct claim-related issues and coordinate with the appropriate team for coding
or documentation corrections.
Submit corrected claims and/or appeals as appropriate.
Track appeals and follow up until final resolution.
3. eClinicalWorks (eCW) Mandatory
Must have hands-on experience working in eClinicalWorks (eCW).
Review patient accounts and claim history.
Review claim status, billing details, insurance information, and payment history.
Document AR follow-up activities in eCW.
Review EOB/ERA information and identify outstanding balances.
Work claim corrections and follow-up activities within the available eCW
workflow.
Understand claim status and billing workflow in eCW.
4. Denial & Claim Resolution
5. AR Aging Management
6. Payment & EOB Analysis
Review EOBs/ERAs to determine:
o Allowed amount
o Paid amount
o Patient responsibility
o Deductible
o Coinsurance
o Copay
o Contractual adjustment
o Denial/remark codes
Identify underpayments and incorrect contractual adjustments.
Coordinate with payment posting and management teams when discrepancies
are identified.
Required Knowledge
US Healthcare Medical Billing
Insurance AR Follow-Up
Denial Management
Claims Follow-Up
eClinicalWorks (eCW) Mandatory
EOB/ERA interpretation
CPT and ICD-10 basics
HCPCS basics
Modifiers
Medical necessity
Authorization/referral requirements
Timely filing
Corrected claims
Appeals
Provider enrollment issues
Coordination of Benefits
Medicare and commercial insurance processes
Payer portals
Clearinghouse/claim submission concepts
Qualifications
23 years of experience in US Healthcare AR/Medical Billing.
Mandatory hands-on experience with eClinicalWorks (eCW).
Good understanding of US insurance processes.
Strong denial management experience.
Excellent verbal communication skills for insurance calls.
Good written communication and documentation skills.
Ability to interpret EOBs/ERAs.
Ability to work independently on claims and denials.
Strong analytical and problem-solving skills.
Good knowledge of MS Excel and basic reporting.
Ideal Candidate
The ideal candidate should not only be able to call insurance companies and obtain
claim status, but should be capable of understanding why a claim denied, identifying
the root cause, taking corrective action, submitting the appropriate
correction/appeal, documenting the action in eCW, and following the claim
through final resolution.
Compensation: 35,000.00 - 45,000.00 per month
Benefits:
Health insuranceWork Location: In person .
