AX
Job Description
Key Responsibilities:
AR Caller:
- Call insurance companies (Payers) to follow up on unpaid or denied claims
- Review claim status, resolve denials or rejections, and escalate unresolved issues
- Understand insurance guidelines, CPT codes, and denial reason codes
- Document call details and update the system with proper status
- Meet daily call volume and productivity targets
Pre-Authorization Executive:
- Verify patient eligibility and insurance benefits (EVBV)
- Obtain pre-authorizations and prior approvals from insurance companies
- Follow up with insurance and providers to ensure approvals are received in time
- Maintain logs and documentation for audits and compliance
- Coordinate with billing and scheduling teams to ensure timely services
Eligibility Criteria:
- Education: Any graduate (Life Sciences or Healthcare background preferred)
- Experience:
- Minimum 6 months to 3 years in AR Calling or Pre-auth in US Healthcare
- Communication Skills:
- Excellent verbal communication and listening skills
- Neutral accent with clarity and confidence
- Familiarity with US healthcare terminologies and claim cycle
Skills Required:
- Knowledge of payer portals, insurance processes, and billing workflows
- Hands-on experience with EHR/RCM systems (Athena, eClinicalWorks, EPIC, etc.)
- Strong problem-solving skills and attention to detail
- Ability to multitask and manage time efficiently
- Goal-driven, with a focus on collections and approvals turnaround