Medical Billing Denials & Appeals Specialist

Job Description:

Accounts Receivable & Denial Management

• Monitor and manage outstanding insurance claims to support the reduction of overall Accounts Receivable (AR) balances.
• Conduct regular follow-ups on denied claims to ensure timely resolution and maximize claim recovery.
• Analyze Electronic Remittance Advice (ERA) reports to identify recurring denial trends and recommend corrective measures.
• Prepare, submit, and track appeals for denied or underpaid claims, ensuring all supporting documentation is accurate and complete.
• Investigate payment discrepancies and escalate complex or unresolved issues to the Billing Manager as needed.
• Maintain up-to-date AR aging reports and provide consistent weekly and monthly performance updates.
• Manage billing and claims processing for specialized services, including TMS, Spravato, and psychological assessments.
• Collaborate with the Billing Manager to achieve AR reduction, recovery, and accuracy targets.

Patient & Provider Communication

• Respond promptly and professionally to billing-related inquiries from patients, providers, and internal teams.
• Review and validate patient account information prior to initiating collections or claim follow-ups.
• Work closely with providers to resolve claim issues, including coding discrepancies and missing documentation.
• Communicate with insurance payers regarding eligibility, prior authorizations, and network participation.
• Address patient concerns with professionalism and empathy, including processing refunds when appropriate.

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 resolution processes.
• Coordinate with U.S.-based billing teams to ensure accurate and timely claim submissions.
• Participate in operational meetings to review performance trends and recommend process improvements.
• Stay informed on payer policies, regulatory requirements, and industry best practices in 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:

• AR: 1 year (Preferred)

Language:

• English (Required)

Work Location: In person