Accounts Receivable Caller

Location: Bengaluru

We are looking for a detail-oriented Accounts Receivable Caller with expertise in hospital or physician billing. The candidate will be responsible for managing billing, claims, and accounts receivable processes while ensuring compliance with regulatory standards.

Key Responsibilities:

Hospital Billing Specialist:
Review patient records and charge sheets for accuracy.
Translate medical services into billable charges.
Prepare and submit insurance claims (CMS-1500 / UB-04).
Verify patient demographics and insurance details.
Monitor claim status and follow up on unpaid or denied claims.
Correct claim errors and resubmit when needed.
Ensure compliance with billing regulations and payer policies.
Maintain patient confidentiality (HIPAA compliance).
Accounts Receivable / Follow-Up Specialist & Denial Management:
Analyze denial reasons and prepare appeals with supporting documentation.
Coordinate with coding, billing, and clinical teams.
Track denial patterns and recommend process improvements.
Verify patient demographics, insurance eligibility, and obtain prior authorizations.
Enter charges into billing systems and ensure clean claims creation.
Submit claims electronically or via paper while meeting filing deadlines.
Post payments from insurance carriers and patients, reconcile EOBs/ERAs, and identify under/over payments.
Monitor unpaid and aging claims, follow up with insurance companies, and reduce days in A/R.
Generate patient statements, explain charges, and collect co-pays, deductibles, and coinsurance.
Medical Coding:
Review clinical documentation and assign accurate ICD-10-CM, CPT, and HCPCS codes.
Ensure coding accuracy and compliance with payer rules.
Apply modifiers correctly (e.g.,
-25,
-59).
Preferred Candidate Profile:
Expertise in Hospital Billing (UB-04) or Physician Billing (CMS-1500).
Strong understanding of claims processing, denial management, RCM basics, and A/R follow-up.
Experience in International Voice Process is mandatory.
Excellent attention to detail, problem-solving, and organizational skills.