Job Description
Key Responsibilities
- Review and analyze assigned insurance claims for payment status, underpayments, and discrepancies
- Follow up with U.S. insurance payers via outbound calls, IVR systems, and payer web portals
- Identify claim issues, ask payer-specific questions, and accurately document responses
- Resolve denials by analyzing denial reasons and initiating corrective actions
- Submit and resubmit claims electronically, via paper, or through Direct Data Entry (DDE) as required
- Prepare detailed call notes and update actions in the client’s revenue cycle management system
- Send required medical records and supporting documentation to payers for claim resolution
- Meet or exceed defined productivity, quality, and compliance benchmarks
- Adhere to client-specific call documentation standards and HIPAA guidelines
Qualifications
- Minimum 2 years of experience in A/R calling for the U.S. healthcare provider market
- Prior experience in a medical billing or revenue cycle management organization preferred
- Strong understanding of end-to-end revenue cycle workflows and denial management processes
- Working knowledge of U.S. insurance plans, HIPAA regulations, Workers’ Compensation, and No-Fault insurance
- Undergraduate degree or higher, or equivalent relevant experience
Skills
- Excellent verbal and written communication skills (English)
- Strong calling etiquette and professional payer interaction skills
- Proficiency in medical billing software and revenue cycle platforms
- Working knowledge of MS Office applications
- Ability to multitask and work efficiently in a fast-paced environment
Additional information
- Client-specific medical billing system training will be provided
- Role requires consistent documentation accuracy and compliance adherence
- Opportunity to work with U.S. healthcare payers and complex claim scenarios
Highlights
TypeFull-Time
LocationPune Office
DepartmentAccounts Receivable
Working DayMonday To Friday
Shift Day Shift
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