01Overview
Roles & Responsibilities
Perform AR follow-up on outstanding insurance claims and denied claims.
Contact insurance companies via calls, IVR, or web portals to obtain claim status.
Investigate and resolve claim denials, underpayments, and payment delays.
Analyze EOBs (Explanation of Benefits) and determine appropriate actions.
Work on denial management and appeals to maximize reimbursements.
Document call outcomes and update claim status accurately in the billing system.
Identify trends in denials and recommend corrective actions.
Follow up on pending claims and ensure timely resolution.
Maintain productivity and quality standards as defined by the organization.
Collaborate with billing and coding teams to resolve claim-related issues.
Required Skills
Knowledge of US Healthcare and Medical Billing processes.
Experience in AR Follow-up and Denial Management.
Understanding of Medicare, Medicaid, and Commercial Insurance policies.
Strong verbal and written communication skills.
Good analytical and problem-solving abilities.
Ability to work with billing software and MS Excel.
Ability to meet productivity and quality targets
