AR Caller Insurance Follow-Up, Denials & Appeals

AR Caller Insurance Follow-Up, Denials & Appeals Job Description Duties: Payer Outbound Telephonic Follow-Up: To settle claims that are still pending in the 30, 60, 90, and 120+ day aging buckets, make daily, high-volume outbound calls to US insurance companies, including Medicare, Medicaid, Blue Cross Blue Shield, Aetna, Cigna, and UnitedHealthcare. Live Claim Status Diagnostics: To find out why claims are pending, trapped in processing loops, or rejected, navigate intricate interactive voice response (IVR) networks and communicate with payer agents. Verbal Denial Troubleshooting: Correct small data problems over the phone by verbally cross-examining claims representatives about partial payments, coordination of benefits (COB) blocks, eligibility inconsistencies, or authorization skips. Real-Time Data Reprocessing Injection: Give payer agents instructions to reprocess claims for prompt adjudication during the call, rectify subscriber ID mismatches, and provide missing demographic updates. Careful Call Log Documentation: Enter the representative's name, reference tracking number, date spoken, and anticipated payment deadlines in full, understandable, and thorough notes for each call into the central billing system. Payer Web-Portal Triangulation: While on hold, concurrently use insurance provider web portals to check filing deadlines, pull digital eligibility slips, and confirm claims metrics. Focus Skills: Excellent verbal communication skills with a neutral accent, clear pronunciation, the capacity to actively listen, and a high level of professional vocabulary to have a seamless conversation with US insurance adjusters. Resilient Phone Stamina & Auditory Focus: Excellent mental toughness to deal with consecutive outbound phone lines, calmly handling long wait times without losing concentration or momentum. Basic Medical Billing Framework Literacy: A practical grasp of basic RCM components, including the meaning of CPT procedure lines, ICD-10-CM codes, and billing modifiers. Denial Language Interpretation Speed: Quickly understand verbal denial explanations by being familiar with common insurance adjustment descriptors. Apply now to become an integral part of our growing team! With Regards, HR - Maria