Accounts Receivable Specialist - RCM

Key Responsibilities :

Perform AR follow-up with insurance companies via calls or web portals to check claim status and expedite payment.

Handle denial management by understanding the reason for denials, initiating corrective actions, and coordinating re-submissions.

Ensure timely and accurate posting of payments and adjustments on already paid claims.

Maintain detailed documentation of all communication and actions taken on accounts.

Work with billing and coding teams to resolve claim issues and prevent recurring errors.

Meet daily and monthly targets for productivity, collections, and quality.

Ensure compliance with HIPAA and company data security policies.

Communicate effectively for any denial trends, suggestions to billing / coding.

Required Skills & Competencies :

Strong understanding of US healthcare billing, insurance, and reimbursement processes.

Experience with EOBs, ERAs, denials, rejections, and claim status follow-ups.

Familiarity with AdvancedMD Preferred (Optional) .

Excellent verbal and written communication skills.

Good analytical, problem-solving, and time-management abilities.

Ability to work independently and meet deadlines in a fast-paced environment.

Qualifications :

Bachelor’s degree in any discipline (Commerce, Healthcare, or related field preferred).

Minimum 3 –5 years of experience in US healthcare AR follow-up / RCM process.

Willingness to work in night shifts (if applicable to US time zone).