AR & Claims Resolution Specialist

Accounts Receivable & Denial Management

• Monitor and manage outstanding insurance claims to support the reduction of overall Accounts Receivable (AR).
• Perform consistent follow-ups on denied claims to ensure timely resolution and claim recovery.
• Analyze Electronic Remittance Advice (ERA) reports to identify denial trends and recommend corrective actions to prevent recurrence.
• Prepare, submit, and track appeals for denied or underpaid claims while ensuring all required documentation is complete and accurate.
• Investigate payment discrepancies and escalate complex issues to the Billing Manager when necessary.
• Maintain updated AR aging reports and provide regular weekly and monthly performance summaries.
• Handle billing and claim management for specialized services such as TMS, Spravato, and psychological assessments.
• Work collaboratively with the Billing Manager to achieve AR reduction, recovery, and billing accuracy objectives.

Patient & Provider Communication

• Respond promptly and professionally to billing-related inquiries from patients, providers, and internal teams.
• Review and verify patient account details to ensure accuracy before initiating collections or claim follow-ups.
• Coordinate with healthcare providers to resolve claim issues related to coding errors or missing documentation.
• Communicate with insurance payers to address eligibility verification, prior authorization requirements, and network participation matters.
• Address patient billing concerns with professionalism and empathy, including processing refunds when applicable.

Systems Management & Process Improvement

• Create, monitor, and resolve billing-related support tickets within the eClinicalWorks (eCW) system.
• Provide guidance and support to team members on AR follow-up strategies and denial management procedures.
• Coordinate with U.S.-based billing teams to facilitate accurate and timely claims submission.
• Participate in operational meetings and performance reviews to evaluate trends and recommend workflow improvements.
• Stay updated on payer guidelines, regulatory requirements, and industry best practices related to medical billing and reimbursement.

Job Type: Full-time

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