Sr. AR Executive (Medical Billing)

Key Responsibilities:

Accounts Receivable (AR) Follow-up

• Follow up on outstanding insurance claims with

  Commercial, Medicare, and Medicaid

  payers.
• Communicate with insurance companies via

  calls, payer portals, and email

  to verify claim status.
• Manage and prioritize claims across

  30/60/90/120+ day aging buckets

  .
• Ensure timely

  reprocessing, resubmission, and appeal

  of unpaid or delayed claims.
• Identify

  underpayments

  and initiate appropriate recovery actions.
• Document all follow-up activities accurately in the billing system.
  

Denial Management

• Review and analyze claim

  denials and rejections

  using

  EOBs and ERAs

  .
• Determine root causes of denials, including

  coding errors, eligibility issues, authorization gaps, timely filing, medical necessity, bundling, and coverage limitations

  .
• Correct errors and resubmit claims with accurate

  codes, modifiers, and supporting documentation

  .
• Prepare and submit

  appeals

  within payer-specific timelines.
• Maintain a

  denial tracking log

  , analyze trends, and suggest preventive actions.
• Collaborate with

  coding, charge entry, eligibility, and front-end teams

  to improve first-pass claim acceptance.

Required Skills & Competencies

• Strong knowledge of

  US Healthcare Revenue Cycle Management (RCM)

  processes.
• Hands-on experience with

  CPT, ICD-10, HCPCS codes, modifiers, and billing guidelines

  .
• Familiarity with

  payer policies, LCD/NCD guidelines, and reimbursement rules

  .
• Excellent

  verbal and written communication

  skills for payer interactions.
• Strong

  analytical, problem-solving, and negotiation

  skills.
• Experience using

  billing systems, payer portals, clearinghouses, and EHR/PM tools

  .
• Ability to meet

  productivity and quality benchmarks

  while managing workloads efficiently.