AR Specialist

Company Description

DOCS MD RCM Healthcare Outsourcing Partners collaborates with organizations across the USA, UK, UAE, and Australia, specializing in services for hospitals, medical practices, dental clinics, vision care, and audiology. The company focuses on providing support for RCM (Revenue Cycle Management) and special healthcare projects. With strong outsourcing partnerships in India, Sri Lanka, Indonesia, Philippines, and Vietnam, DOCS MD RCM ensures efficient and high-quality services to meet client needs.

Role Description

🔹Medical & Dental AR Specialist (5+ Years Experience)📌

Accounts Receivable Management

Manage the full AR cycle for medical and dental claims, ensuring accurate and timely follow-up.Monitor outstanding balances and maintain AR aging reports within targeted benchmarks.Identify, analyze, and resolve claim denials, rejections, and underpayments.📌

Claims Processing & Follow-Up

Perform daily follow-up with insurance carriers, payers, and TPAs to expedite claim resolution.Resubmit corrected claims, appeal denied claims, and track claim status until reimbursement is received.Ensure compliance with payer-specific billing rules, CDT/CPT codes, modifiers, and coverage guidelines.📌

Insurance Verification & Eligibility

Verify patient insurance benefits, coverage limitations, deductibles, and co-pays for medical and dental services.Collaborate with front-desk teams to resolve eligibility gaps and documentation issues.📌

Payment Posting & Adjustments

Post insurance and patient payments accurately into the billing system.Review EOBs/ERAs to apply adjustments, write-offs, and reconcile discrepancies.Maintain 100% accuracy in payment posting and balance matching.📌

Denial Management

Conduct root-cause analysis on recurring denials and implement preventive strategies.Prepare and submit timely appeals with proper supporting documentation.Work closely with providers, coders, and billing teams to minimize future denials.📌

Patient Communication

Assist in resolving patient billing inquiries in a professional and compassionate manner.Educate patients regarding insurance balances, statements, and payment options (as needed).📌

Reporting & Documentation

Maintain detailed records of all claim activities, payer communications, and status updates.Generate weekly and monthly AR performance reports to management.Track KPIs such as Days in AR, First-Pass Resolution Rate, Denial Rate, and Monthly Collections.📌

Compliance & Quality Control

Ensure adherence to HIPAA, coding standards, and compliance guidelines.Stay updated on changes in insurance policies, payer rules, CDT/CPT updates, and reimbursement trends.Identify process gaps and recommend improvements to increase AR efficiency.