We Are Hiring | AR Specialist | US RCM Healthcare

Role & responsibilities

• Perform AR follow-up for US Healthcare Provider-side accounts across Professional Billing (PB) and/or Hospital Billing (HB).
• Review aging reports, outstanding balances, and unpaid claims.
• Conduct insurance/payer follow-up through payer portals and phone calls.
• Identify reasons for non-payment, underpayment, rejection, or denial and take appropriate action.
• Handle claim status checks, payment issues, authorization-related issues, eligibility issues, and payer-related discrepancies.
• Analyze EOBs/ERAs to identify payment, denial, adjustment, and patient responsibility details.
• Follow up on underpaid and incorrectly paid claims and initiate appropriate action.
• Work on timely filing, medical necessity, authorization, coding-related, eligibility, and other payer denial categories.
• Prepare and submit appropriate appeals and reconsiderations for eligible denied claims.
• Identify recurring denial trends and communicate them to the relevant team.
• Maintain accurate AR account notes and follow-up documentation.
• Prioritize accounts based on aging, balance, payer, denial reason, and recovery potential.
• Meet defined productivity, quality, collections, and turnaround-time targets.
• Coordinate with Billing, Coding, Payment Posting, Charge Entry, and other RCM teams.
• Ensure proper follow-up on accounts until resolution or appropriate disposition.

Preferred candidate profile

• 2+ years of hands-on experience in US Healthcare Provider-side Accounts Receivable (AR).
• Practical experience in Professional Billing (PB) and/or Hospital Billing (HB).
• Strong knowledge of insurance/payer AR follow-up and claim status verification.
• Experience in denial and rejection management.
• Knowledge of EOB/ERA and payment, denial, adjustment, and patient responsibility details.
• Experience with insurance portals and payer calling/voice process.
• Knowledge of appeals and reconsiderations.
• Good understanding of AR aging, timely filing, authorization, eligibility, medical necessity, and coding-related denials.
• Good communication and documentation skills.
• Ability to work according to US Healthcare RCM processes and client-specific SOPs.

Experience: 2+ Years
Location: Pune / Ahmedabad
Employment Type: Full-Time (Work from office)