Medical AR & Claims Resolution Specialist

Key ResponsibilitiesAccounts Receivable & Denials Management

• Monitor and manage outstanding insurance claims to reduce overall accounts receivable (AR) balances.
• Review and resolve claim denials on a daily basis, ensuring timely and accurate follow-up.
• Analyze Electronic Remittance Advice (ERA) data to identify recurring denial trends and implement corrective actions.
• Prepare, submit, and track appeals for denied or underpaid claims with appropriate documentation.
• Investigate payment discrepancies, escalating complex issues to the Billing Manager as needed.
• Maintain and update AR aging reports; provide regular weekly and monthly performance updates.
• Process claims for specialized services, including TMS, Spravato, and psychological testing.
• Partner with the Billing Manager to achieve AR resolution and collection targets.

Patient & Provider Support

• Respond to billing-related inquiries from patients, providers, and internal teams.
• Review and update patient accounts, ensuring accuracy before initiating collection actions.
• Collaborate with providers to correct claim errors, including coding and documentation.
• Coordinate with insurance companies regarding prior authorizations, coverage verification, and network status.
• Address patient concerns with professionalism, including issuing refunds when appropriate.

System Support & Process Improvement

• Submit and monitor support tickets in eClinicalWorks (eCW) to resolve billing-related issues.
• Provide training and support to team members on AR and denial management processes.
• Collaborate with U.S.-based teams to ensure timely and accurate claim submissions.
• Participate in team meetings to review AR performance, analyze trends, and recommend process improvements.
• Stay current with payer policies, compliance regulations, and industry best practices.

Job Type: Full-time

Pay: Rs40,000.00 - Rs80,000.00 per month

Ability to commute/relocate:

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

Application Question(s):

• Willing to work the night shift?

Experience:

• Medical Billing: 1 year (Preferred)

Language:

• English (Preferred)

Work Location: In person