AR Process for Medical Services Client Support

AR Process for Medical Services Client Support Job Description: The main "Revenue Recovery Engine, Denial Resolution Specialist, Insurance Payer Communications Anchor & Cash Flow Guardian " for our healthcare RCM and medical billing operations is the AR Caller in Medical Billing Revenue Cycle Management, Claims Denial Management, Insurance Follow-up & RCM Analytics Specialist. Your main responsibility is to actively follow up on unpaid, delayed, rejected, or denied medical insurance claims while RCM Managers, Billing Directors, Compliance Officers, and Practice Managers set high-level operational policies, payer fee schedules, clean claim submission benchmarks, and financial performance frameworks. Key Duties: Insurance Follow-Up & Outstanding Claim Tracking: To find out the status of outstanding claims in ageing buckets, make daily outbound phone calls and check online with US business and government insurance payers. Claims Denial Management & Root-Cause Analysis: Examine medical claims that have been rejected, refused, or partially paid by examining EOB/ERA statements, determining the precise denial reason codes, and taking prompt corrective action. Appeals Preparation & Re-Submission: To prepare, package, and submit formal claims appeals, reconsideration requests, and corrected claims within stringent payer timely filing deadlines, collect the clinical data, medical records, and physician notes that are required. Insurance and Patients Demographic Verification: To fix problems in claim submission and resubmit clean claims, audit patient demographic records, insurance policy numbers, group numbers, coverage effective dates, and primary/secondary coordination of benefits. Payer Compliance & HIPAA Standards Maintenance: During all verbal and written insurance interactions, strictly abide by healthcare compliance regulations, such as the Health Insurance Portability and Accountability Act HIPAA, the Health Information Technology for Economic and Clinical Health HITECH Act, and payer-specific guidelines. We invite you to apply and explore this exciting opportunity Warm Regards, HR - Maria