AR Caller
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 endtoend revenue cycle activities including insurance followups, 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 highvolume calls and multitask efficiently.
Analytical thinking for rootcause analysis of denials.
Proficiency in medical billing software, EMRs, and MS Office tools.
Strong attention to detail, time management, and documentation accuracy.
Customercentric and problemsolving 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