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).
Account Specialist • Vizianagaram, Andhra Pradesh, India