Accounts Receivable & Claims Associate

We are seeking a detail-oriented and results-driven Accounts Receivable & Claims Resolution Specialist to join our Revenue Cycle team. This role is responsible for managing insurance accounts receivable, resolving claim denials, maximizing reimbursement, and supporting initiatives that improve overall revenue cycle performance. The ideal candidate possesses strong analytical and problem-solving skills, a thorough understanding of medical billing processes, and the ability to collaborate effectively with providers, payers, patients, and internal teams to ensure timely claim resolution and optimal financial outcomes.

Key ResponsibilitiesAccounts Receivable & Claims Management

• Monitor and manage outstanding insurance receivables to reduce aging accounts and improve cash collections.
• Perform timely follow-up on denied, rejected, pending, and unpaid claims to secure accurate reimbursement.
• Analyze Electronic Remittance Advice (ERA) and Explanation of Benefits (EOB) reports to identify denial trends, payment variances, and recurring issues.
• Prepare, submit, and track first-level and subsequent appeals for denied or underpaid claims, ensuring supporting documentation is complete and submitted within payer deadlines.
• Investigate payment discrepancies, underpayments, coordination of benefits issues, and unresolved claims while escalating complex cases when appropriate.
• Maintain accurate accounts receivable aging reports and provide regular updates on productivity, collections, and denial trends.
• Process claims and reimbursement activities for specialty services, including TMS, Spravato, psychological evaluations, and other behavioral health services.
• Partner with Revenue Cycle leadership to achieve departmental goals related to reimbursement optimization, AR reduction, and revenue recovery.

Payer, Provider & Patient Coordination

• Serve as a primary liaison with insurance companies regarding claim status, eligibility verification, prior authorizations, payer requirements, and reimbursement issues.
• Collaborate with providers and clinical teams to resolve coding discrepancies, documentation deficiencies, and claim-related issues.
• Review patient accounts to ensure demographic, insurance, and billing information is accurate before initiating follow-up activities.
• Respond professionally to billing inquiries from patients, providers, insurance representatives, and internal departments.
• Assist with account adjustments, refunds, and billing corrections while providing exceptional customer service.

Revenue Cycle Operations

• Create, monitor, and resolve billing support tickets within eClinicalWorks (eCW) and other revenue cycle platforms.
• Collaborate with U.S.-based billing teams to ensure timely claim submission, payment posting, denial resolution, and reimbursement.
• Participate in departmental meetings to review key performance indicators, identify process improvements, and support operational initiatives.
• Stay current with payer policies, coding updates, reimbursement guidelines, and regulatory requirements to ensure compliance and billing accuracy.
• Contribute to workflow improvements that enhance operational efficiency, reduce denials, and strengthen overall revenue cycle performance.

Qualifications & Core Competencies

• Strong knowledge of medical billing, accounts receivable management, insurance claims processing, denial management, and revenue cycle operations.
• Comprehensive understanding of commercial insurance, Medicare, Medicaid, payer reimbursement methodologies, and appeals processes.
• Excellent analytical, investigative, and critical thinking skills with strong attention to detail.
• Effective communication and relationship-building skills when working with patients, providers, insurance carriers, and internal stakeholders.
• Proficiency with eClinicalWorks (eCW), practice management systems, Electronic Remittance Advice (ERA), EOB analysis, and revenue cycle reporting tools.
• Strong organizational and time-management skills with the ability to prioritize multiple responsibilities while meeting productivity and quality standards.
• Ability to work independently and collaboratively in a fast-paced healthcare environment while maintaining confidentiality and compliance with HIPAA regulations.

Pay: Rs45,000.00 - Rs70,000.00 per month

Ability to commute/relocate:

• Wapda Town: Reliably commute or planning to relocate before starting work (Required)

Application Question(s):

• Willing to work the night shift in Wapda Town, Lahore

Experience:

• Medical BIlling: 1 year (Preferred)

Language:

• English (Required)

Work Location: In person