AR Caller / AR Follow up (RCM) – Senior Executive

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About the Position:

AR Denials – Senior Executive

Accounts Receivable (AR) follow-up and Denial Management

No Authorization, Duplicate, Bundled, Inclusive, COB (Coordination of Benefits), and others.

Key Responsibilities:

• Manage AR follow-up focusing on denial resolution and recovery
• Analyze denials including No Auth, Duplicate, Bundled, Inclusive, COB, Non-Covered, Medical Necessity, Timely Filing, etc
• Contact insurance companies to check claim status, understand denial reasons, and take corrective actions
• Verify accurate insurance details and patient registration data on behalf of clients
• Communicate with clients regarding potential coding, billing, or documentation issues
• Submit claims via billing software (electronic and paper) and ensure accuracy in submissions
• Follow up on unpaid or denied claims within the standard billing cycle timeframe
• Research, resolve, and appeal denied or rejected claims with appropriate supporting documents
• Perform eligibility and benefit verification through web portals or over the phone
• Review patient bills for completeness and accuracy; obtain and rectify any missing information
• Process payments including ERA (Electronic Remittance Advice) and EOB (Explanation of Benefits) posting
• Understand and apply insurance payer policies including HMO, PPO, Medicare, Medicaid, and Commercial plans
• Maintain accurate documentation of all actions in the system
• Ensure compliance with HIPAA and internal quality standards
  

Required Skills & Qualifications:

• Minimum 2 years of hands-on experience in US Healthcare AR follow-up and Denial Management
• Strong understanding of denial types including No Auth, COB, Bundled, Duplicate, Inclusive, and other payer-specific denial reasons
• Knowledge of payer rules, coordination of benefits (COB), and appeals processes
• Familiarity with charge entry, claim submission, and payment posting (ERA/EOB)
• Ability to read and interpret superbills and medical billing data
• Strong verbal and written communication skills
• Detail-oriented with the ability to multitask and meet productivity targets
• Familiarity with credentialing is a plus
• Proficient in handling Protected Health Information (PHI) in line with HIPAA compliance
  

Why Join Us?

• Be part of a collaborative and growing team
• Competitive compensation and performance-based incentives
• Opportunities for skill development in the healthcare RCM domain
• Stable work environment with a focus on professional growth