RCM AR Specialist (US Healthcare)

RCM AR Specialist Pune (Work from Office) | Night Shift: 7:30 PM 4:30 AM IST

We're hiring RCM AR Specialists to join our Revenue Cycle Management team in Pune. In this role, you'll own the recovery and management of accounts receivable for our US healthcare clients. You'll research and follow up on medical insurance claims, prepare appeals, and work directly with insurance carriers to resolve claims and hit our AR targets.

What you'll do

• Follow up on unpaid claims using aging reports, correspondence, clearinghouse and PM rejections, and client practice management systems
• Handle complex payer denials and prepare effective appeals
• Make sure secondary claims are processed and paid
• Monitor and reconcile held and unbilled vouchers, denial trends, patient balances, and credits/refunds
• Answer and resolve client, patient, and carrier calls and requests promptly
• Track and manage information requests to clients
• Meet productivity, quality, and compliance goals, including 1,400 accounts worked per month
• Mentor new team members as needed

What you'll bring

• Experience in US healthcare AR calling and denial management
• Working knowledge of CPT, ICD-10, and modifiers
• Familiarity with Medicare Fee-for-Service, commercial payers, HMOs, and IPAs
• Experience with billing systems such as Epic, NextGen, Allscripts, or similar
• Comfort using payer websites and Laserfiche, plus basic MS Office skills
• Specialty experience in Psychiatry, Internal Medicine, Orthopedics, or General Surgery is a plus
• MS Access, PowerPoint, or Crystal Reports experience is a plus
• Strong communication and customer service skills

Working arrangements

• Willingness to work night shifts from our Pune office
• After-hours and on-call support may be needed during peak periods (month, quarter, and year end), when PTO is limited