Medical Claims & Denials Specialist

Job Title: Accounts Receivable & Denials Resolution Specialist – Medical Billing
Location: Wapda Town, Lahore
Pay: PKR 40,000 – 70,000/month

We are seeking a detail-oriented and proactive Accounts Receivable & Denials Resolution Specialist to join our medical billing team. In this role, you will oversee outstanding insurance claims, manage denials, and ensure timely reimbursements from payers. The ideal candidate is analytical, organized, and able to communicate professionally with patients, providers, and insurance representatives.

Key Responsibilities

Accounts Receivable & Denial Management

• Monitor and manage pending insurance claims to reduce AR balances.
• Review and resolve claim denials daily, ensuring timely follow-up.
• Analyze ERA reports to identify recurring denial patterns and recommend corrective actions.
• Prepare, submit, and track appeals for denied or underpaid claims with proper documentation.
• Investigate payment discrepancies and escalate complex cases to the Billing Manager.
• Maintain and update AR aging reports with weekly and monthly updates.
• Handle claims for specialized services such as TMS, Spravato, and psychological assessments.
• Collaborate with the Billing Manager to achieve AR resolution and collection goals.

Patient & Provider Coordination

• Respond to billing inquiries from patients, providers, and internal teams.
• Verify and correct patient accounts before initiating collection actions.
• Work with providers to resolve claim errors, including coding and documentation.
• Coordinate with insurance payers on authorizations, eligibility, and network issues.
• Resolve patient billing concerns professionally and process refunds as needed.

System & Process Efficiency

• Submit and track support tickets in eClinicalWorks (eCW) for billing issues.
• Train and assist team members on AR and denial workflows.
• Collaborate with U.S.-based teams to ensure accurate and timely claim submissions.
• Participate in team meetings to review AR performance, analyze trends, and recommend improvements.
• Stay up-to-date on payer policies, compliance requirements, and industry best practices.

Job Type: Full-time

Pay: Rs40,000.00 - 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