AR Callers & Authorization Associates-RCM US Healthcare

AR Callers :

• Experience:1- 4 years
• Number of vacancies: 5
• Good understanding of Accounts Receivable.
• Call Insurance companies on behalf of physicians and carry out a further examination on outstanding Accounts Receivables Prioritize unpaid claims for calling according to the length of time it has been outstanding Call insurance companies directly and convinces them to pay the outstanding claims
• Check the relevance of insurance info offered by the patient Evaluate unpaid insurance claims
• Call insurance companies and check on the status of claims Transfer the outstanding balance to the patient if he/she doesn't have adequate insurance coverage If the claim has already been paid, ask the insurance company for Explanation of Benefits (EOB) Make corrections to the claim based on inputs from the insurance company
• Excellent communication skills, both written and verbal. Able to present information and solutions in a professional and courteous manner.
• Excellent attention to detail and accuracy.
• Able to organize and prioritize tasks in order to complete all work assigned
• Experience in Athena Advanced MD, Allscripts & Kareo will be an added advantage
• A keen eye for detail.
• An ability to work independently.
• Should be willing to work in Night shift. Work from office only. (Uppal & Madhapur)

Authorization Associate :

• Experience: 1- 4 years
• Number of vacancies: 5
• Obtains prior-authorizations and referrals from insurance companies prior to procedures or Surgeries utilizing online websites or via telephone.
• Monitors and updates current Orders and Tasks to provide up-to-date and accurate information.
• Provides insurance company with clinical information necessary to secure prior-authorization or referral.
• Good understanding of the medical terminology and progress notes.
• Works in alignment with Central Scheduling and Pre Encounter Departments.
• Obtains necessary electronic referrals needed from scheduled specialty appointments.
• Obtains and/or reviews patient insurance information and eligibility verification to obtain prior-authorizations for injections, DME, Procedures, and surgeries.
• Request retro-authorizations when needed.
• Communicates with practices when prior-authorization is unable to be obtained and requires peer-to-peer and/or different study.
• Document the detail notes and attach the approved Auth/Referral to patient encounters.
• Software preferences: All Scripts, eCW, ModMed, EPIC.
• Should be willing to work in Night shift. Work from office only.