Roles & Responsibilities (AR Caller):
• Follow up with insurance companies for claim status
• Handle denials and take corrective actions
• Work on re-submissions and appeals when required
• Maintain documentation and call logs as per process guidelines
• Meet daily targets for productivity and call quality
• Initiate and follow up on prior authorization requests with payers
• Coordinate with providers, patients, and insurance representatives
• Ensure timely submission of requests and track status updates
• Verify eligibility and benefits for procedures/services and call insurance for accurate coverage details
• Maintain accurate records of authorization approvals and denials
• Candidate should be aware of CMS guidelines, payment policies of Federal and Commercial payors.
• LCD/NCD guidelines, CCI edits, modifier usage.
• Candidates with RPM, CCM and RTM billing exposure would be an advantage.
• Candidates should be open-minded and willing to take additional responsibility as per business needs.