US Healthcare - RCM Process

1. AR Caller (Accounts Receivable Caller) Job Responsibilities: Follow up with insurance companies regarding unpaid or denied claims. Check claim status, payment details, and denial reasons. Resolve billing issues and reprocess claims when required. Document call outcomes and update billing systems. Work to maximize collections and reduce aging balances. Skills Required: Knowledge of US Healthcare Revenue Cycle Management (RCM). Good communication and analytical skills. Experience with insurance portals and claim follow-up.

2. EV/BV Executive (Eligibility Verification / Benefits Verification) Job Responsibilities: Verify patient insurance eligibility and benefits before services. Confirm coverage, copay, deductible, coinsurance, and authorization requirements. Update patient insurance information in the system. Communicate verification results to internal teams. Ensure accurate documentation and compliance. Skills Required: Knowledge of insurance plans and verification processes. Attention to detail and data accuracy. Good communication skills.

3. Payment Posting Executive Job Responsibilities: Post insurance and patient payments accurately into the billing system. Reconcile EOBs/ERAs with received payments. Identify and report payment variances, denials, and underpayments. Process adjustments, write-offs, and refunds as required. Maintain payment posting accuracy and productivity targets. Skills Required: Knowledge of EOB, ERA, CPT, ICD, and medical billing processes. Strong attention to detail and numerical accuracy. Experience with payment posting software and spreadsheets. Experience Requirement (Typical):0–2 Years: Junior Executive2+ Years: Senior Executive / Specialist US Healthcare RCM experience preferred.