AR Caller Healthcare Payer Follow-Up

AR Caller Healthcare Payer Follow-Up Job Description: The AR Caller (Medical Billing) manages revenue cycle management (RCM) operations, claim follow-ups with U.S. healthcare insurance payers, denial resolution, claims appeals, and outstanding accounts receivable recovery. This role ensures timely reimbursement for healthcare providers, reduces Days in Accounts Receivable (DAR), minimizes write-offs, enforces HIPAA compliance, and maintains precise tracking of claim statuses and payment clearing metrics Key Duties: Claim Tracking and AR Collections: Contact U.S. insurance payers (Medicare, Medicaid, Commercial, HMO/PPO) by phone and web portal to check claim status, process unpaid customer account balances, and expedite claim processing. Denial management and discrepancy resolution: Analyze claim denials/denial codes (ANSI comments/reason codes) to identify root causes of nonpayment, gather missing clinical documentation and coding updates, and resubmit corrected claims. Appeals and Dispute Processing. Draft and submit formal written appeals, reconsideration requests, and supporting documentation for wrongly denied or underpaid claims within payer-defined filing deadlines (TFLs). Compliance with HIPAA and payer regulations: Strictly adheres to HIPAA regulations, patient health information (PHI) security protocols, state healthcare laws, and payer billing regulations during all communications. RCM Analysis and General Ledger Tracking: Use spreadsheets and practice management systems to record daily appeal decisions, claim resolution notes, denial trends, pending statute of limitations tranches, and collectability projections. We invite you to apply and explore this exciting opportunity! Warm Regards, HR - Maria