AR Calling (Denial Management) in Medical Billing RCM

Name: AR Calling (Denial Management) in Medical Billing RCM
Rating: 4.3 (112 reviews)

"Job-Ready Skills for AR Calling and Denial Management in U.S. Revenue Cycle"

Created byB Yadgiri

Last updated 12/2025

English

What you'll learn

Understand the U.S. healthcare system and insurance terminology, including payer types (Medicare, Medicaid, Commercial, etc.).
Explain the medical billing workflow, including patient registration, charge entry, claim submission, and payment posting.
Perform AR calling professionally, using scripts and soft skills to follow up with insurance companies regarding unpaid or denied claims.
Identify and analyze common claim denials, such as timely filing, medical necessity, coordination of benefits (COB), authorization issues, and more.
Document call outcomes clearly and accurately in the billing system using appropriate follow-up actions.
Develop communication skills to speak confidently with U.S. insurance representatives and explain billing issues to providers or supervisors.
Prepare for job interviews and mock calls as an AR Caller in real-world U.S. healthcare revenue cycle management (RCM) settings

Course content

1 section • 111 lectures • 2h 17m total length

Introduction1:38
2. For Whom This Course is Designed0:31
3. Who is an AR Caller and Basic Requirements to become an AR Caller.3:14
4. The Future of AR Callers in the Medical Industry4:22
5. What is AR (Accounts Receivable) and What is the Medical Billing Process2:01
6. What is Revenue Cycle Management (RCM)7:10
7. What Does the AR Team Do and Why Are There Unpaid Claims4:17
8. 3 P’s in Medical Industry are Provider, Payer and Patient.1:01
9. Premium0:22
10. Benefits0:17
11. Beneficiary0:16
12.Subscriber0:21
13.Dependent0:13
14.Primary Care Physician (PCP)0:24
15.HIPAA0:21
16.NPI – National Provider Identifier0:23
17. What is PTAN1:18
18.Tax ID Number0:15
19. CMS – Centers for Medicare and Medicaid Services0:22
CMS administers the Medicare program and collaborates with states to manage Medicaid, ensuring high quality care under government health programs.
20. SSN – Social Security Number0:25
21. MRN (Medical Record Number)0:10
22. Account Number0:10
23. Effective Date0:10
24.Termination Date0:10
25. Insurance Identification Number (Insurance ID)0:22
26.Primary Insurance0:22
27.Secondary Insurance0:21
28.Tertiary Insurance0:22
29.Coordination of Benefits (COB)0:35
30.Medicare Crossover0:24
31.Birthday Rule0:47
32.Claim and What is a Corrected Claim1:39
A claim is a medical bill sent to the insurance company for payment of services. A corrected claim fixes errors in a previously submitted bill, not a new claim.
33.In-Patient0:09
34.Out-Patient0:13
35.Insurance Claim Number0:09
36.Assignment of Benefits (AOB)0:15
37.Explanation of Benefits (EOB)0:31
38. What is DOS (Date of Service) and Why is DOS important1:17
39. Date of Bill0:11
40.Billed Amount0:12
41.Allowed Amount0:38
42.Insurance Payable Amount0:16
43.Write-Off Contractual Adjustment0:49
44.Out-of-Pocket Expense0:30
45.Deductible, Why deductibles exist and Cost Sharing0:46
46.Co-Insurance0:27
47.Co-Payment (or Co-Pay)0:28
48.Balance Bill0:41
49. Participating Provider (In-Network Doctor or Hospital)0:39
50. Non-Participating Provider (Out-of-Network)0:27
51. Credentialing0:19
52. Fee Schedule0:18
53. Contract Maximum0:22
54. Referral0:30
55. Pre-Authorization Pre-Certification0:51
56.Claim Form Types CMS-1500 , UB-040:51
57.Type of Bill (TOB)0:40
58. Place of Service (POS) and Common Place of Service Codes2:11
59. Claim Filing Limit0:25
60. Capitation0:36
61. Durable Medical Equipment (DME)0:24
62. Diagnosis-Related Groups (DRGs)0:29
63. Ambulatory Payment Classifications (APC)0:17
64. CLIA – Clinical Laboratory Improvement Amendments0:25
65. What is an ABN, What Must Be Included in a Valid ABN2:08
66. Medicare , Who is Eligible for Medicare, Parts of Medicare2:19
67. Medicaid, Who is Eligible for Medicaid1:52
68. Worker’s Compensation (WC) , Who Pays for It0:53
69. TRICARE (formerly CHAMPUS) , What Does TRICARE Do0:42
70. CHAMPVA, What’s Covered0:33
71. Commercial Insurance (Private Insurance), PPO , HMO2:40
72. Commercial Insurance (Private Insurance), POS, EPO1:20
73. COBRA, How Long Does COBRA Last1:41
74. The Affordable Care Act (Also Known as ObamaCare), Main Goals of the Afforda1:33
75. What is Medical Coding and Why Coding is Important1:48
76. What is Medical Transcription and Why is Medical Transcription Important1:25
77. ICD – International Classification of Diseases and Why is ICD Important1:45
78. Current Procedural Terminology – 4th Edition (CPT) and Why is CPT Important0:57
79.HCPCS – Healthcare Common Procedure Coding System1:34
80.What Are Revenue Codes and Why Are Revenue Codes Important2:00
81.What Is a Global Surgical Fee , Major vs. Minor Surgeries1:54
82.What Are Modifiers in Medical Billing , Common Modifier Examples3:41
83. Sections of CPT Codes (Current Procedural Terminology)2:52
84. Who is a Fresher AR Caller,What Does a Fresher AR Caller Do2:48
85. What Does an AR Caller with 2 Years of Experience Do, What is Expected from2:26
86. What is EOB, What does an EOB show1:08
87. What is ERA1:19
88. What is Overpayment, What is Underpayment1:43
89. OFFSET , RECOUPMENT , REFUND2:18
90. Most Common Denials in AR Calling3:57
Identify the most common AR calling denials, from missing or duplicate claims and invalid patient information to eligibility, pre-authorization, coding, medical necessity, and COB issues.
91.Top Questions AR Callers Should Ask When a Claim Is Denied3:08
92.What is Root Cause Analysis (RCA) for Denials, Common Areas to Check During R2:29
93.What does “Claim Not on File” mean , Possible Reasons Why a Claim is “Not on1:53
94.What is a Duplicate Claim , Why Does a Duplicate Claim Happen2:16
95.What Does “InvalidMissing Patient Information” Mean1:15
96.What Does “EligibilityPolicy Not Active” Mean , Common Reasons for This Denia1:24
97.What is Invalid or Missing AuthorizationReferral, Common Reasons for Denial1:35
98.What is Retroactive Authorization , When is Retroactive Authorization Allowed2:05
99.What Does Procedure Not Covered Mean1:50
100. What is “Timely Filing Limit Exceeded1:47
101. What is Coordination of Benefits (COB)1:29
102. What is Bundled Services1:39
103. What Does Incorrect or Missing Modifier Denial Mean1:42
104. What is a Medical Necessity Denial1:34
105. What is an Out of Network Provider , Reasons for Denial due to Out of Netw1:34
106. What is Patient Responsibility , Why Claims Show Patient Responsibility1:49
107. Why Claims Get Denied for Incorrect CPTICD Codes1:56
108. What Does “Claim Denied as Paid” Mean2:00
109. What Does “Maximum Benefits Exhausted” or “Met” Mean1:53
110. What Are Non-Covered Services0:57
111. Pro Tip for AR Callers0:23

Requirements

Educational Qualification: Minimum: High school diploma or equivalent (12th grade pass). Preferred: Any degree or diploma in commerce, life sciences, or healthcare.
English Communication Skills: Basic spoken and written English proficiency. Ability to understand U.S. accents and speak clearly over the phone.
Computer Literacy: Comfortable using a computer, keyboard, mouse, and web applications. Basic knowledge of MS Excel and email usage is helpful.
Listening & Typing Skills: Good listening skills and the ability to type notes during live or mock calls.
Willingness to Work U.S. Shifts (for job-oriented programs): Students should be open to working night shifts or U.S. time zones, as most AR caller jobs follow that schedule.
Positive Attitude & Professionalism: Willingness to learn, take feedback, and work in a fast-paced, target-driven environment.
Any Graduate who is interested in Healthcare Domain.

Description

AR Calling (Denial Management) in Medical Billing RCM is a comprehensive, training program designed to equip students and professionals with the practical skills required to succeed in the U.S. healthcare revenue cycle management (RCM) industry. This course focuses specifically on the Accounts Receivable (AR) follow-up process and denial management—a critical area where medical billing companies recover lost revenue by working with insurance providers to resolve unpaid or rejected claims.

In this course, you will learn the complete workflow of the U.S. medical billing process, with a deep focus on the AR calling function. You’ll gain a clear understanding of how health insurance works in the U.S., including the types of payers (Medicare, Medicaid, Commercial), common claim issues, and how to professionally follow up with insurance representatives to resolve those issues.

You will be trained in identifying and analyzing denial reasons such as timely filing, lack of authorization, medical necessity, coordination of benefits (COB), and more. Using real-world scenarios and mock calls, the course provides hands-on experience in making effective insurance follow-up calls, documenting call results, and taking appropriate next steps such as re-submitting claims or initiating appeals.

Whether you are a fresher, a graduate from any stream, or someone looking to shift into a more stable and rewarding career in the healthcare BPO industry, this course will prepare you for entry-level AR Caller roles with top medical billing companies.

Upon completion, students will be ready to attend interviews and perform effectively as AR callers in a real-world U.S. healthcare billing environment.

By the end of this course, students will be confident in handling AR calling tasks, managing unresolved claims, documenting call outcomes, and contributing directly to the revenue goals of any U.S. healthcare provider or billing company.

Who this course is for:

Freshers and Job Seekers Looking to start a career in U.S. healthcare revenue cycle management (RCM) or medical billing with no prior experience.
Graduates in Life Sciences, Commerce, or Arts Including BSc, BCom, BBA, BCA, BA, or any degree holders seeking healthcare BPO or voice process jobs.
Medical Billing Trainees Who want to specialize in AR calling or denial management roles in U.S. medical billing companies.
Working Professionals From non-voice or backend roles in medical billing who want to transition to a voice-based AR calling profile.
BPO / Call Center Professionals Looking to move into the healthcare domain with better career stability and U.S. process exposure.
Anyone Seeking a Job in U.S. Shift (Night Shift) Especially those targeting roles in MNCs, healthcare BPOs, or medical billing service providers.