الوصف الوظيفي
About the Company: HBox.
ai is a US-based HealthTech company that uses AI and remote monitoring technology to help doctors manage patients outside of hospitals.
Their platform enables virtual care, chronic disease management, and continuous patient monitoring, especially in specialties like cardiology, pulmonology, and nephrology.
About the Role: The AR Caller/RCM Specialist is responsible for managing end‑to‑end revenue cycle activities including insurance follow‑ups, denial resolution, prior authorization processing, eligibility verification, and documentation.
The role ensures timely reimbursements, accurate submissions, and smooth coordination between providers, patients, and payers.
Roles & Responsibilities (AR Caller): • Follow up with insurance companies for claim status • Handle denials and take corrective actions • Work on re-submissions and appeals when required • Maintain documentation and call logs as per process guidelines • Meet daily targets for productivity and call quality • Initiate and follow up on prior authorization requests with payers • Coordinate with providers, patients, and insurance representatives • Ensure timely submission of requests and track status updates • Verify eligibility and benefits for procedures/services and call insurance for accurate coverage details • Maintain accurate records of authorization approvals and denials • Candidate should be aware of CMS guidelines, payment policies of Federal and Commercial payors.
• LCD/NCD guidelines, CCI edits, modifier usage.
• Candidates with RPM, CCM and RTM billing exposure would be an advantage.
• Candidates should be open-minded and willing to take additional responsibility as per business needs.
Required Skills & Competencies: • Strong communication skills (verbal and written) with clarity and professionalism.
• Good understanding of US healthcare terminologies, payer rules, CPT/ICD codes.
• Knowledge of denial types, AR workflows, and prior authorization processes.
• Ability to handle high‑volume calls and multi‑task efficiently.
• Analytical thinking for root‑cause analysis of denials.
• Proficiency in medical billing software, EMRs, and MS Office tools.
• Strong attention to detail, time management, and documentation accuracy.
• Customer‑centric and problem‑solving mindset, technology oriented.
Qualifications: • Bachelor’s degree or equivalent education • Preferred 1–3 years in AR Calling/Prior Authorization and RCM (End to End claim handling) • Certification in Medical Billing or RCM (added advantage).
• Freshers with strong communication skills may be considered, depending on role level
لقد تمت ترجمة هذا الإعلان الوظيفي بواسطة الذكاء الاصطناعي وقد يحتوي على بعض الاختلافات أو الأخطاء البسيطة.
