As an AR Follow-up Analyst, you will play a crucial role in managing the insurance claims process for US-based healthcare practices. This position focuses on maximizing insurance reimbursements, identifying claim issues, and resolving payment denials. The ideal candidate will have experience working with US medical insurance claims and will ensure smooth interactions with insurance carriers and practice owners.
Key Responsibilities
- Insurance Claim Follow-up:
- Follow up with US-based insurance carriers on unpaid, underpaid, or delayed claims.
- Root Cause Analysis & Appeals:
- Identify causes for claim denials or underpayments and initiate the appeal process.
- Collaborate with Practice Owners and Clinicians:
- Work with US-based healthcare providers to correct missing or incorrect claim data.
- Claim Processing:
- Ensure claims align with ICD-10, CPT, HCPC codes and correct CMS-1500 and UB-04 claim formats.
- Optimize Payment Processes:
- Propose resolutions to maximize reimbursement and streamline the insurance process.
Qualifications
- Experience:
- Minimum 6 months of experience in US-based AR follow-up and payment posting.
- Industry Knowledge:
- Familiarity with the US medical insurance system and claims processing cycle.
- Working knowledge of ICD-10, CPT, HCPC codes, CMS-1500, and UB-04 formats.
- Software Experience:
- Prior experience with Vericle software is a must.
- Skills:
- Excellent communication, listening, and problem-solving skills.
- Self-motivated and able to work independently.
Requirements
- Work Hours:
- Must be comfortable working in US Eastern Time Zone (night shift).
- Equipment:
- Laptop/Desktop with at least 8 GB RAM.
- Reliable internet connection and mobile hotspot backup.
- Work Environment:
- Ability to work remotely from home.
Why Join Vericle?
- Flexible remote work environment with opportunities to work with international clients.
- Exposure to the US healthcare system and industry-standard tools.
- Collaborative and supportive virtual work culture.
