RCM AR Analyst

Job Summary

The Associate will be responsible for managing assigned Denied and Accounts Receivable (AR) claims, ensuring timely resolution while meeting productivity and quality benchmarks. The role involves close coordination with the Team Manager, strict adherence to SOPs and internal tools, and a strong focus on first-time resolution to minimize multiple follow-ups.

Key Roles & Responsibilities

• Work daily assigned denied and AR follow-up claims and resolve them in coordination with the Team Manager.

• Ensure assigned claims are completed within defined productivity and quality targets.

• Adhere strictly to SOPs and internal tools to maintain high-quality claim resolution.

• Focus on resolving claims effectively rather than repeated follow-ups, minimizing multiple touches.

• Prioritize work orders using various strategies such as:

• High aging claims

• High-dollar claims

• Payer-wise prioritization

• Run reports to perform deep-dive analysis and identify bulk claim issues.

• Identify trends and root causes to reduce denials and prevent avoidable rework.

Education Qualification

• Education Level: Bachelor’s Degree

• Field of Study: Graduation in any stream

Required Experience & Qualifications

• Minimum 2+ years of experience in US Healthcare RCM with a focus on AR Calling.

• Experience handling both Federal and Commercial insurance payers in a provider setup.

• Strong knowledge of billing scrubbers, clearing house, and payer rejections.

• Good understanding of major AR scenarios across multiple payers.

• Excellent communication and analytical skills.

• Strong multitasking ability, including taking detailed call notes and collaborating with multiple stakeholders.