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ar representative medical billing

Physicians Revenue Group

Job SummaryWe are looking for an AR Specialist to manage accounts receivable activities, including claim follow-ups, payment posting review, and issue resolution, to ensure timely collections and maximum reimbursement. The candidate should have working knowledge of US medical billing and AR processes.Key Responsibilities<ul><li>Perform AR follow-ups on unpaid and underpaid insurance claims.</li><li>Review claim status, EOBs, and ERAs to identify payment issues.</li><li>Work on basic denials, rejections, and corrected claims as required.</li><li>Communicate with insurance companies via calls and payer portals.</li><li>Update claim status and maintain accurate AR records.</li><li>Ensure compliance with HIPAA and payer guidelines.</li><li>Meet assigned productivity and turnaround time targets.</li></ul>Required Skills &amp; Experience<ul><li>6 months or more experience in AR / US Medical Billing.</li><li>Basic knowledge of CPT, ICD-10, and HCPCS codes.</li><li>Experience handling EOBs, ERAs, and AR aging reports.</li><li>Familiarity with Medicare, Medicaid, and Commercial payers.</li><li>Good communication and follow-up skills.</li><li>Willingness to work in night shift (US time zone).</li></ul>Job Type: Full-timeAbility to commute/relocate:<ul><li>Lahore Johar Town: Reliably commute or planning to relocate before starting work (Preferred)</li></ul>Education:<ul><li>Middle School (Preferred)</li></ul>Experience:<ul><li>2year: 1 year (Preferred)</li></ul>Work Location: In person

AR Representative - Medical Billing

Job Description: Physicians Revenue Group (PRG) is looking for a detail-oriented and experienced QA Billing Executive to join our growing Medical Billing team. The ideal candidate should have strong experience in Accounts Receivable (AR) and a good understanding of quality assurance processes in medical billing. The role involves reviewing billing processes, identifying errors, and ensuring compliance with company standards and client requirements.Key Responsibilities:<ul><li>Perform quality checks on AR and billing processes to ensure accuracy and compliance.</li><li>Review claims, denials, and payment postings to identify errors or inconsistencies.</li><li>Monitor team performance and provide feedback to improve billing quality.</li><li>Ensure adherence to medical billing guidelines and client requirements.</li><li>Prepare QA reports and highlight areas of improvement.</li><li>Coordinate with AR teams to resolve billing issues and maintain quality standards.</li></ul>Requirements:<ul><li>Minimum 1 years of experience in Medical Billing (AR).</li><li>Basic understanding of QA processes in medical billing.</li><li>Strong analytical and problem-solving skills.</li><li>Good communication and reporting skills.</li><li>Ability to work in a Night Shift environment.</li><li>Attention to detail and ability to maintain accuracy.</li></ul>What We Offer:<ul><li>Competitive salary package</li><li>Professional work environment</li><li>Career growth opportunities in medical billing</li></ul>Location: Lahore Shift: Night ShiftJob Type: Full-timeWork Location: In person

QA Billing Executive

Diglip

We are seeking a highly experienced Laboratory Billing Specialist / RCM Manager to oversee and optimize all aspects of our diagnostic laboratory billing operations. This role will act as the internal billing authority, working closely with our third-party billing company to ensure clean claim submission, minimize denials, and maximize reimbursement.The ideal candidate must have deep expertise in clinical laboratory billing, coding, payer guidelines, and denial management, and should be capable of identifying gaps, resolving issues, and implementing process improvements.Key Responsibilities<ul><li>Oversee and audit the performance of the external billing company</li><li>Review and ensure clean claim submission (first-pass resolution)</li><li>Analyze and resolve denials (CO-45, CO-97, CO-16, PR-96, etc.)</li><li>Identify root causes of denials and implement corrective workflows</li><li>Monitor AR (Accounts Receivable) and aging reports</li><li>Ensure proper usage of CPT codes, ICD-10 codes, modifiers (e.g., 59, 91, 25)</li><li>Validate medical necessity compliance (LCD/NCD guidelines)</li><li>Manage payer-specific requirements (Medicare, Medicaid, BCBS, Aetna, UHC, etc.)</li><li>Work on eligibility verification and benefits investigation</li><li>Review EOBs/ERAs and payment posting accuracy</li><li>Ensure proper credentialing and enrollment (NPI, CLIA, PECOS, CAQH)</li><li>Maintain compliance with HIPAA and CMS billing regulations</li><li>Coordinate with lab operations for proper test coding &amp; panel setup</li><li>Optimize workflows for high-volume tests (CBC, CMP, Ferritin, Toxicology, etc.)</li><li>Track rejection trends and clearinghouse errors</li><li>Generate weekly/monthly billing performance reports</li><li>Implement strategies to reduce write-offs and maximize collections</li></ul>Required Skills &amp; ExpertiseCore Billing Knowledge<ul><li>Strong understanding of Laboratory Billing (Clinical &amp; Toxicology preferred)</li><li>Expertise in:</li><li>CPT / HCPCS coding</li><li>ICD-10 diagnosis coding</li><li>Modifiers usage</li><li>Medical necessity rules</li><li>Hands-on experience with:</li><li>Denial Management &amp; Appeals</li><li>AR Follow-ups</li><li>Insurance Verification</li><li>Charge Entry &amp; Payment Posting</li></ul>Technical &amp; System Skills<ul><li>Experience with LIS (Laboratory Information Systems) and billing software</li><li>Familiarity with Clearinghouses (Office Ally, Change Healthcare, etc.)</li><li>Knowledge of EDI transactions (837, 835, 270/271)</li><li>Ability to audit data between LIS and Billing Systems</li><li>Strong Excel / Google Sheets skills for reporting &amp; analytics</li></ul>Payer &amp; Compliance Knowledge<ul><li>Experience handling:</li><li>Medicare / Medicaid billing</li><li>Commercial insurance (BCBS, Aetna, UHC, Cigna, etc.)</li><li>Understanding of:</li><li>LCD/NCD policies</li><li>Frequency limitations</li><li>Bundling &amp; unbundling rules</li><li>Familiarity with CLIA regulations for lab billing</li></ul>Credentialing &amp; Enrollment<ul><li>Experience with:</li><li>Provider Enrollment (PECOS, CAQH)</li><li>NPI registration and maintenance</li><li>CLIA certification handling</li><li>Ability to ensure lab is properly enrolled with all payers</li></ul>Preferred Qualifications<ul><li>Experience working with high-complexity labs or toxicology labs</li><li>Prior experience managing or auditing outsourced billing teams</li><li>Knowledge of HL7 integrations and lab-machine workflows</li><li>Certification such as:</li><li>CPB (Certified Professional Biller)</li><li>CPMA / CPC (AAPC)</li></ul>Key Performance Indicators (KPIs)<ul><li>Reduction in denial rate (%)</li><li>Increase in clean claim rate</li><li>Improvement in AR days</li><li>Recovery of underpaid / denied claims</li><li>Accuracy in coding and billing compliance</li></ul>Note: Candidates without hands-on lab billing experience will not be considered.Job Type: Full-timePay: Rs150,000.00 - Rs200,000.00 per monthApplication Question(s):<ul><li>How many years of US laboratory billing experience do you have?</li><li>Have you worked with denial codes like CO-45, CO-97, CO-16, PR-96?</li><li>Are you comfortable working onsite and night shifts (US hours)?</li></ul>Work Location: In person

Laboratory Billing Specialist / Revenue Cycle Manager (RCM)

* Prepare, review, and submit medical claims to insurance companies.* Ensure all billing information is accurate and complete before claim submission.* Verify patient demographics, insurance details, and billing codes.* Follow payer guidelines and billing regulations to reduce claim rejections.* Maintain daily productivity and quality targets.* Coordinate with the AR and QA teams for claim corrections or resubmissions.* Update billing records in the system and maintain proper documentation.* Identify and report billing issues or discrepancies to the supervisor.Job Type: Full-timeApplication Question(s):<ul><li>How would you rate your communication skill out of 5?</li><li>Are you available for working at 07:oo pm to 04:00 am ?</li><li>How many Years experience do you have in Medical Billing ?</li></ul>Education:<ul><li>Bachelor's (Required)</li></ul>Experience:<ul><li>2year: 1 year (Required)</li></ul>Work Location: In person

Billing Executive - Production

Physician Cure

AR Executive with the experience of 1-3 year is required in TriTech services Medical billing company located at 20-L Ex air avenue DHA phase 8 Lahore. WhatsApp 0326-4565645Shift timing 7pm to 4amJob Type: Full-timePay: Rs60,000.00 - Rs70,000.00 per monthWork Location: In person

AR Executive for Medical Billing company

Top Line Resource Group (TLRG)

Location: DHA Phase 8, Lahore [Onsite]Employment Type: Full-timeWork Timing: 05 PM &ndash; 02 AM Pakistan Time (US Business Hours)Job OverviewTopline Resource Group (TLRG) is seeking a dedicated Eligibility &amp; Authorization Specialist to manage the critical front-end operations for our US-based healthcare clients. This role is focused entirely on securing the financial foundation of the practice by ensuring every patient has active coverage and every procedure has the required clinical approval before services are rendered.Key Responsibilities<ul><li>Verify patients' insurance coverage and eligibility in real-time to ensure policies are active and services are covered on the specific Date of Service (DOS).</li><li>Obtain pre-authorizations from insurance companies for medical procedures and treatments.</li><li>Communicate directly with patients regarding their insurance status, coverage specifics, and any required actions or out-of-pocket responsibilities.</li><li>Maintain accurate and meticulous records of insurance verifications and authorizations, including representative names and unique reference numbers for audit trails.</li><li>Collaborate with healthcare providers to ensure all necessary clinical information, physician notes, and CPT/ICD-10 codes are obtained for successful pre-authorizations.</li><li>Monitor and follow up on pending authorizations daily to ensure timely processing and stay within the 7&ndash;10 day payer response window.</li><li>Analyze insurance benefits to identify exact copays, unmet deductibles, and co-insurance percentages to ensure accurate front-end collections.</li><li>Identify if the provider is in-network or out-of-network and determine if specific plan tiers (HMO/EPO) require a PCP referral before the visit.</li><li>Stay up to date with insurance policies, CMS regulations, and HIPAA guidelines to ensure 100% compliance across all US healthcare accounts.</li><li>Track and manage KPIs, including the clean claim rate and authorization turnaround time, to reduce AR aging and increase collection rates.</li></ul>Required Qualifications<ul><li>3+ years of experience in US Medical Billing, specifically focused on Front-End operations (Eligibility and Authorizations).</li><li>Expert-level familiarity with CPT, ICD-10, and HCPCS codes and their specific relationship to authorization requirements.</li><li>Deep understanding of US insurance plans, including Medicare, Medicaid, HMO, PPO, and Commercial plans.</li><li>Hands-on experience with EHR/EMR systems, Practice Management software, and major US payer portals (Availity, Navinet, etc.).</li><li>Excellent verbal and written English communication skills for professional interaction with US insurance companies and clinical teams.</li><li>Strong analytical ability to interpret Verification of Benefits (VOB) reports and payer medical necessity criteria to resolve issues before service delivery.</li></ul>Pay: Rs100,000.00 - Rs125,000.00 per monthExperience:<ul><li>eligibility &amp; authorization: 2 years (Required)</li></ul>Work Location: In person

Eligibility & Authorization Specialist

Location: DHA phase 8, Lahore (Onsite)Work Schedule: 05PM &ndash; 02AM Pakistan TimeEmployment Type: Full-time (Night Shift)We are seeking a dynamic and results-driven Senior HR Specialist with a strong focus on recruitment and talent acquisition, along with hands-on exposure to HR operations. This role is ideal for someone experienced in hiring for BPO and US-based medical billing environments, with the ability to build strong talent pipelines and manage end-to-end recruitment in a fast-paced setting.Key Responsibilities:1. Recruitment &amp; Talent Acquisition (Primary Focus)<ul><li>Lead end-to-end recruitment for roles including Medical Billing (AR, RCM), Customer Support, and Accounting</li><li>Develop and post job advertisements across relevant platforms (LinkedIn, Indeed, job portals, referrals)</li><li>Actively source candidates through headhunting, networking, and database building</li><li>Screen, shortlist, and schedule interviews for potential candidates</li><li>Coordinate with hiring managers to ensure a smooth and timely recruitment process</li><li>Build and maintain a strong talent pipeline for current and future hiring needs</li></ul>2. Onboarding &amp; HR Operations<ul><li>Prepare offer letters, employment contracts, and onboarding documentation</li><li>Conduct orientation sessions for new employees</li><li>Maintain employee records and HR databases accurately</li><li>Ensure smooth onboarding experience and documentation compliance</li></ul>3. Employee Relations &amp; Engagement<ul><li>Serve as a point of contact for employee concerns, grievances, or queries</li><li>Organize employee engagement activities and internal events</li><li>Promote a positive, inclusive, and high-performance work environment</li></ul>4. Performance Management<ul><li>Support implementation of performance appraisal systems</li><li>Track probation evaluations and ensure timely performance reviews</li><li>Assist managers in setting employee KPIs and monitoring progress</li></ul>5. HR Policy &amp; Compliance<ul><li>Ensure compliance with labor laws and company policies</li><li>Draft and update HR policies, procedures, and employee handbooks</li><li>Maintain strict confidentiality of employee information</li><li>Manage attendance, leaves, and disciplinary actions as per company standards</li></ul>6. Payroll &amp; Benefits Administration<ul><li>Assist in monthly payroll processing by maintaining attendance and leave data</li><li>Coordinate employee benefits such as insurance and incentives</li><li>Handle exit formalities and full &amp; final settlements</li></ul>Requirements:<ul><li>3&ndash;4 years of HR experience, with a strong focus on recruitment in BPO / Medical Billing</li><li>Bachelors/Masters in HRM or related field.</li><li>Proven expertise in sourcing, headhunting, and pipeline building</li><li>Experience in bulk hiring and fast-paced recruitment environments</li><li>Strong command of LinkedIn, job portals, and sourcing techniques</li><li>Excellent English communication skills (written &amp; verbal)</li><li>Ability to multitask and meet hiring targets under pressure</li></ul>Preferred Skills:<ul><li>Experience hiring for US-based clients</li><li>Familiarity with ATS systems and recruitment KPIs</li><li>Exposure to full HR lifecycle (onboarding to exit)</li></ul>Pay: Rs90,000.00 - Rs120,000.00 per monthApplication Question(s):<ul><li>What sourcing platforms and techniques do you actively use for hiring?</li><li>What is your average time-to-fill for a role, and how do you ensure fast hiring in a high-volume environment?</li><li>How many roles do you typically handle at one time, and what types of positions have you hired?</li></ul>Experience:<ul><li>360 recruitment: 3 years (Required)</li></ul>Work Location: In person

Senior HR Specialist – Recruitment & Operations

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