AR Callers & Denial Management, EVBV, Authorization Specialists – (Medical Billing)

Key Responsibilities for AR: Review account thoroughly, including any prior comments on the account, EOBs / ERAs / Correspondence, and perform pre-resolution analysis. Understand the reason for rejection, denials, or no status from the payer. Work on the resolution of the claim by performing follow-up with the payer using the most optimal method, i.e., calling, IVR, web, or email. Take appropriate action to move the account towards resolution, including rebilling the claim, sending claims for reprocessing, reconsideration, redetermination, appeal (portal/web, fax, mail), verifying eligibility and benefits, and managing management hand-off with the client and internal teams. Documentation of all the actions on the practice management system and workflow management system, and maintain an audit trail. Ensure adherence to Standard Operating Procedures and compliance. Highlight any global trend/pattern and issue escalation with the leadership team. Meet the productivity and quality target ...