OnSure Health LLC
Website:
onsurehealth.com
Job details:
Job Description – US Healthcare AR Caller
Position: AR Caller / AR Executive – US Healthcare
Experience: 1–5 Years
Work Mode: Work from Office
Shift: US Shift / Night Shift
Industry: US Healthcare / Medical Billing/Physician Billing
Key Responsibilities
- Contact US insurance companies through calls and payer portals to check claim status and payment details.
- Follow up on outstanding, unpaid, pending, denied, rejected, and underpaid claims.
- Review and analyze EOBs (Explanation of Benefits) and ERAs (Electronic Remittance Advice).
- Identify the reason for claim denials and determine the appropriate resolution.
- Work on common denials such as:
- Timely Filing
- No Authorization
- Medical Necessity
- Non-Covered Services
- Duplicate Claims
- Coordination of Benefits (COB)
- Eligibility-related issues
- Coding/billing-related issues
- Initiate appropriate corrective actions, including claim correction, resubmission, reconsideration, and appeals.
- Follow up on appeals and documentation submitted to insurance companies.
- Review and work on AR aging reports and prioritize accounts based on aging, balance, and claim status.
- Maintain accurate and detailed notes for every payer interaction and follow-up.
- Coordinate with billing, coding, payment posting, and other internal teams for claim resolution.
- Escalate complex or unresolved claims to the appropriate team/client.
- Ensure claims are followed up within defined turnaround times.
- Meet assigned daily productivity, quality, collection, and resolution targets.
- Maintain compliance with HIPAA, client SOPs, payer guidelines, and company policies.
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