Senior Ar Caller

Lumeratek Pvt Ltd; Hyderabad; Sur place; INR 300 000 - 520 000; Plein temps

Résumé du poste

Lumeratek Pvt Ltd in Hyderabad, India seeks a diligent Billing Specialist to handle insurance follow-ups, verify claim status, and manage denials with accuracy. The role involves payment posting support, AR management, and close collaboration with billing and coding teams to resolve issues.

Experience in medical billing and HIPAA compliance is required, with night shifts for US timings. The candidate should have strong communication skills, Excel proficiency, and a detail-oriented approach to

Qualifications

• Experience in medical billing, insurance claims, denial management, and AR follow-ups
• Knowledge of UShealthcare billing processes and denial codes
• Ability to navigate HIPAA requirements and maintain data integrity
• Strong communication and negotiation skills
• Willingness to work night shifts (US timings)

Responsabilités

• Contact insurance companies to check status of pending medical claims
• Review and verify claim details, payment status, denials, and rejections
• Analyze reasons for claim denials and take actions like re-submission
• Assist in identifying underpayments or overpayments and report discrepancies
• Work on AR queues to reduce outstanding balances and improve cash flow
• Document call details, claim updates, and actions in the system
• Initiate appeals for denied claims and follow up until resolution
• Ensure timely follow-ups on unpaid or partially paid claims within TAT
• Coordinate with billing, coding, and internal teams to resolve claim issues
• Meet daily/weekly/monthly targets for calls, collections, and quality

Connaissances

US healthcare knowledge

HIPAA compliance

Communication skills

Night shifts

Excel

Billing software

Attention to detail

Problem-solving

Teamwork

Negotiation

Formation

Any graduate

Commerce / Life Sciences / Pharmacy background advantageous

Outils

Medical billing software

Billing systems

MS Excel

Description du poste

Role & responsibilities

• Insurance Follow-ups:
  Contact insurance companies (via calls or portals) to check the status of pending medical claims.
• Claim Status Verification:
  Review and verify claim details, payment status, denials, and rejections.
• Denial Management:
  Analyze reasons for claim denials and take necessary actions such as re-submission or escalation.
• Payment Posting Support:
  Assist in identifying underpayments or overpayments and report discrepancies.
• Accounts Receivable Management:
  Work on assigned AR queues to reduce outstanding balances and improve cash flow.
• Documentation:
  Accurately document call details, claim updates, and actions taken in the system.
• Appeals & Reprocessing:
  Initiate appeals for denied claims and follow up until resolution.
• Timely Follow-ups:
  Ensure regular follow-ups on unpaid or partially paid claims within TAT (Turnaround Time).
• Compliance:
  Maintain compliance with HIPAA guidelines and company policies.
• Coordination:
  Work closely with billing, coding, and internal teams to resolve claim issues.
• Productivity & Quality Targets:
  Meet daily/weekly/monthly targets in terms of calls, collections, and quality standards.
• Good communication and negotiation skills
• Knowledge of US healthcare/medical billing process
• Understanding of insurance policies and denial codes
• Basic computer skills (Excel, billing software)
• Attention to detail and problem-solving ability

Preferred candidate profile

• Educational Qualification:
  Any graduate (Commerce / Life Sciences / Pharmacy background is an advantage)
• Communication Skills:
  Excellent verbal communication skills with neutral accent and good listening ability
• Process Knowledge:
  Strong understanding of medical billing, insurance claims, denial management, and AR follow-ups
• Technical Skills:
  Basic knowledge of MS Excel and medical billing software/tools
• Analytical Skills:
  Ability to analyze claim denials and take appropriate action for resolution
• Work Flexibility:
  Willingness to work in night shifts (US timings)
• Target-Oriented:
  Ability to meet productivity, quality, and collection targets
• Team Player:
  Good interpersonal skills and ability to coordinate with internal teams
• Adaptability:
  Quick learner with the ability to handle multiple tasks and work under pressure