denial management specialist

HRMD Solutions

IMPORTANT: Please read before applying&#9989; ONLY candidates with AR/ collections or Medical Billing will be considered.&#10060; Applicants without relevant healthcare experience (e.g., teaching, engineering, IT, sales, etc.) will be automatically rejected.Job Description:The AR Follow up Specialist will play a critical role in managing and collecting outstanding accounts receivable within the revenue cycle management process. This position requires fluency in English to effectively communicate with our diverse client base. The ideal candidate will have a strong background in collections within the healthcare industry in USA, exceptional communication skills, and the ability to work independently in a fast-paced environment.<ul><li>Full on site in Gulberg 3, Lahore</li><li>Night shifts only 6 pm- 3 am</li></ul>Key Responsibilities:<ul><li>Check eligibility and benefit verification by calls and web portals.</li><li>Review and verify medical codes, including CPT, ICD-10, and HCPCS.</li><li>Review and transmit corrected claims electronically or by paper according to the payers requirements.</li><li>Monitor and follow on unpaid or denied claims to ensure timely resolution.</li><li>Contact insurance companies to inquire about claims status and facilitate payment.</li><li>Review aging reports regularly to prioritize and address delinquent accounts.</li><li>Initiate apples, for denied or underpaid claims and track the appeal process.</li><li>Develop and implement denial management strategies to minimize future denials.</li><li>Main up-to-date documentation and detailed records of appeals.</li><li>Strong understanding of insurance policies, reimbursement methodologies and billing guidelines.</li><li>Collaborate with billing and coding teams to address recurring issues.</li><li>Investigate and resolve any discrepancies in payments, adjustments, or denials.</li><li>Identify claim processing issues and general billing trends.</li></ul>Qualifications:<ul><li>Bachelor&rsquo;s Degree from any reputed institute or University.</li><li>1 to 2 years&rsquo; Experience in Medical Billing- Accounts receivable and denial management.</li><li>Knowledge and understanding of USA health insurance guidelines especially Medicare and state Medicaid</li><li>Experience to work on Pain Management, Anesthesia, Psych/ TMS, RTM, CCM.</li></ul>Job Type: Full-timeJob Type: Full-timePay: Rs85,000.00 - Rs125,000.00 per monthApplication Question(s):<ul><li>Do you live in lahore?</li><li>Are you willing to work night shift (On-site)?</li></ul>Work Location: In person

AR Specialist

TruBridge

<div><div>Accounts Receivable Analyst 
 
<ul><li>2 Years of mandate experience in AR calling with Acute care/Acute business.</li></ul></div><div></div><ul><li>Perform pre-call analysis and check the status by calling the payer or using IVR or web portal services.</li></ul><div></div><ul><li>Maintain adequate documentation on the client software to send the necessary documentation to insurance companies and maintain a clear audit trail for future reference.</li><li>Record after-call actions and perform post-call analysis for the claim follow-up.</li><li>Provide accurate information to the insurance company, research available documentation including authorization, physician notes, medical documentation on PM system, interpret explanation of benefits received, etc. prior to making the call.</li><li>Perform analysis of accounts receivable data and understand the reasons for underpayment, days in A/R, top denial reasons, use appropriate codes to be used in documentation of the reasons for denials/underpayments.</li><li>Comply with all reimbursement and billing procedures for regulatory, third party, and insurance compliance norms.</li><li>Responsible for meeting daily/weekly productivity and quality reasonable work expectations.</li></ul>
Responsibilities 
<ul><li>Claim processing and submission.</li><li>Submit the claim to insurance companies to receive payment for services rendered by a healthcare provider.</li><li>Taking denial status from various insurance carriers</li><li>Checking eligibility and verification of policy</li><li>Analysis of the data</li><li>Converting denials into payments</li><li>Follow Health Insurance Portability and Accountability Act (HIPAA)</li><li>Account follow up on fresh claims, denials, and appeals.</li><li>Checking the claim status as per their suspension and denials</li><li>Achieving weekly/monthly production and audit target</li></ul>
Qualifications/Requirements 
<ul><li>High School (HSC) or graduate or equivalent with strong analytical skills.</li><li>2 Years of experience in accounts receivable follow-up/denial management for US healthcare.</li><li>Good written and verbal communication skills.</li><li>Knowledge of medical terminology, ICD10, CPT, and HCPC coding.</li><li>Basic working knowledge of computers.</li><li>Willingness to work continuously in night shifts.</li></ul>
Preferred 
<ul><li>Familiar with healthcare patient billing systems (Practice management) like NextGen, eCW, Carecloud, Docutap.</li><li>Familiar with clearinghouse like Waystar, Realmed Availity, change healthcare, via track.</li><li>Proficiency with MS Excel, MS Word, google spreadsheet, etc.</li></ul>
Other Skills and Abilities 
<ul><li>Ability to work independently with minimal supervision.</li><li>Good analytical skills, assertive in resolving unpaid claims.</li><li>Ability to multi-task and accurately process high volumes of work.</li><li>Strong organizational and time management skills</li></ul><div>
Individual Contributor</div></div>

Account Receivable Analyst

eServMD Pvt. Ltd.

eServMD Pvt Ltd is a service provider company based in Islamabad Pakistan providing services to US-based companies and clients in the field of Electronic Medical Records (EMR), Medical Practice Management, Medical Billing, Real Estate, Accounts &amp; Finance.We are seeking experienced and detail-oriented A/R Specialists to join our team.Responsibilities:<ul><li>Work on CPT/ICD coding to ensure accurate and compliant billing practices.</li><li>Review patient bills for accuracy, completeness, and obtain any missing information.</li><li>Knowledge of insurance guidelines, especially Medicare and state Medicaid, to ensure proper billing procedures.</li><li>Follow up on unpaid claims within the standard billing cycle timeframe.</li><li>Check each insurance payment for accuracy and compliance with contract discounts.</li><li>Contact insurance companies regarding any discrepancies in payments, if necessary.</li><li>Identify and bill secondary or tertiary insurances.</li><li>Review all accounts for insurance or patient follow-up.</li><li>Answer patient or insurance telephone inquiries related to assigned accounts.</li><li>Communicate effectively with team members and clients.</li><li>Perform account receivables, denial management, and appeal management.</li><li>Maintain protocols and documentation for each performed task.</li><li>Assist with any other tasks as assigned by management.</li><li>Maintain strong verbal communication skills in English.</li></ul>Job Specification:<ul><li>Minimum 1-3 years of experience in Medical Billing.</li><li>Excellent working knowledge of EHRs and medical billing software such as CureMD, Kareo, ECW, Practice Fusion, MS Office, Web Fax (Metro Fax), Encoder pro, Payer Portals, and other related tools and software.</li><li>Strong knowledge of medical billing and coding practices.</li><li>Experience in denial management and appeals.</li><li>Proficient in handling authorization processes (pre, post, and retro).</li><li>Ability to conduct research and generate management reports.</li><li>Must be a team player and collaborate effectively with colleagues.</li><li>Strong verbal and written communication skills in English, including good typing speed.</li><li>Familiarity with infrastructure as code of conduct.</li><li>Excellent problem-solving and troubleshooting skills.</li><li>Experience in accounts receivable follow-up.</li><li>Denial management experience for multi-specialty groups.</li><li>Ability to handle insurance calling and retrieval of EOBs.</li><li>Efficient and fluent communication with external entities.</li><li>Familiarity with insurance account receivable processes.</li></ul>Job Type: Full-timeJob Type: Full-timeWork Location: In person

Medical Billing A/R Specialist

<div><div>Accounts Receivable Analyst 
Mandate 3 +yrs experience in AR Ambulatory services. 
<ul><li>Perform pre-call analysis and check the status by calling the payer or using IVR or web portal services.</li><li>Maintain adequate documentation on the client software to send the necessary documentation to insurance companies and maintain a clear audit trail for future reference.</li><li>Record after-call actions and perform post-call analysis for the claim follow-up.</li><li>Provide accurate information to the insurance company, research available documentation including authorization, physician notes, medical documentation on PM system, interpret explanation of benefits received, etc. prior to making the call.</li><li>Perform analysis of accounts receivable data and understand the reasons for underpayment, days in A/R, top denial reasons, use appropriate codes to be used in documentation of the reasons for denials/underpayments.</li><li>Comply with all reimbursement and billing procedures for regulatory, third party, and insurance compliance norms.</li><li>Responsible for meeting daily/weekly productivity and quality reasonable work expectations.</li></ul>
Responsibilities 
<ul><li>Claim processing and submission.</li><li>Submit the claim to insurance companies to receive payment for services rendered by a healthcare provider.</li><li>Taking denial status from various insurance carriers</li><li>Checking eligibility and verification of policy</li><li>Analysis of the data</li><li>Converting denials into payments</li><li>Follow Health Insurance Portability and Accountability Act (HIPAA)</li><li>Account follow up on fresh claims, denials, and appeals.</li><li>Checking the claim status as per their suspension and denials</li><li>Achieving weekly/monthly production and audit target</li></ul>
Qualifications/Requirements 
<ul><li>High School (HSC) or graduate or equivalent with strong analytical skills.</li><li>1-3 Years of experience in accounts receivable follow-up/denial management for US healthcare.</li><li>Good written and verbal communication skills.</li><li>Knowledge of medical terminology, ICD10, CPT, and HCPC coding.</li><li>Basic working knowledge of computers.</li><li>Willingness to work continuously in night shifts.</li></ul>
Preferred 
<ul><li>Familiar with healthcare patient billing systems (Practice management) like NextGen, eCW, Carecloud, Docutap.</li><li>Familiar with clearinghouse like Waystar, Realmed Availity, change healthcare, via track.</li><li>Proficiency with MS Excel, MS Word, google spreadsheet, etc.</li></ul>
Other Skills and Abilities 
<ul><li>Ability to work independently with minimal supervision.</li><li>Good analytical skills, assertive in resolving unpaid claims.</li><li>Ability to multi-task and accurately process high volumes of work.</li><li>Strong organizational and time management skills</li></ul></div><div>
Individual Contributor</div></div>

AR Analyst(Ambulatory)

Ryan Stone- RPO Services

Senior Associate &ndash; RCM Accounts Receivable (AR)Location: Turbhe,Department: Revenue Cycle ManagementShift Timing: 6:00 PM to 3:00 AM ISTEmployment Type: Full-TimeRole Overview:As a Senior Associate , you will be responsible for managing the end-to-end accounts receivable process within the healthcare revenue cycle. This includes following up on outstanding claims, resolving denials, and ensuring timely payments from insurance providers. The role demands strong communication skills, analytical thinking, and a thorough understanding of payer guidelines and denial management.Core Responsibilities:<ul><li>Call Insurance Companies: Make outbound calls to insurance providers to follow up on outstanding claims and expedite payments.</li><li>Resolve Claim Issues: Investigate and resolve denied or underpaid claims by reviewing Explanation of Benefits (EOBs) and coordinating with internal teams.</li><li>Ensure Timely Payment: Work proactively to ensure claims are paid on time, including correcting errors and appealing denials.</li><li>Maintain Records: Accurately document all communications and claim statuses in the billing system.</li><li>Collaborate Internally: Work closely with medical billing, coding, and other internal teams to resolve discrepancies and improve processes.</li><li>Stay Updated: Keep current with insurance policies, payer guidelines, procedures, and regulatory changes.</li><li>Meet Targets: Achieve daily and monthly AR collection goals and contribute to overall team performance.</li></ul>Required Skills &amp; Qualifications:<ul><li>Graduate in any discipline.</li><li>1 to 5 years of experience in Accounts Receivable within the healthcare domain.</li><li>Strong verbal and written communication skills.</li><li>Sound knowledge of Denial Management and Payer Guidelines.</li><li>Familiarity with medical billing, RCM processes, and healthcare software.</li><li>Detail-oriented with strong follow-up and organizational skills.</li><li>Ability to manage time effectively and work in a fast-paced environment.</li><li>Analytical and problem-solving mindset.</li></ul>Preferred Skills:<ul><li>Knowledge of end-to-end Revenue Cycle Management.</li><li>Experience working with US healthcare insurance providers.</li><li>Exposure to AR tools and systems used in healthcare settings.</li></ul>Job Type: Full-timePay: Up to &#8377;600,000.00 per yearBenefits:<ul><li>Commuter assistance</li><li>Health insurance</li><li>Leave encashment</li><li>Life insurance</li><li>Paid sick time</li><li>Paid time off</li><li>Provident Fund</li></ul>Work Location: In person

Sr Associate- AR (RCM)

ZH Healthcare

<ul><li>Experienced in AR calling, Denial Management, checking eligibility and Authorization verification.</li><li>Calling Insurance companies on behalf of physicians and carryout further examination on outstanding Accounts Receivables.</li><li>Prioritize unpaid claims for calling according to the length of time it has been outstanding. Call insurance companies directly and convince them to pay the outstanding claims.</li><li>Check the relevance of insurance info offered by the patient. Evaluate unpaid insurance claims.</li><li>Call insurance companies and check on the status of claims and verifying authorization.</li><li>Transfer the outstanding balance to the patient of he/she doesn&rsquo;t have adequate insurance coverage.</li><li>If the claim has already been paid, ask the insurance company for Explanation of Benefits (EOB).</li><li>Make corrections to the claim based on inputs from the insurance company.</li><li>Good organizational skills to implement timely follow-up.</li><li>Willingness to work in night shifts and weekends.</li><li>Excellent verbal and written communication skills.</li><li>Strong reporting skills. Ability to follow established work schedule.</li><li>Ability to follow instructions precisely.</li></ul>Job Types: Full-time, PermanentPay: &#8377;8,086.00 - &#8377;35,000.00 per monthBenefits:<ul><li>Health insurance</li><li>Provident Fund</li><li>Work from home</li></ul>Work Location: Remote

AR Caller

247 HealthMedPro

Job Summary:We are seeking experienced and energetic AR Callers to join our Revenue Cycle Management (RCM) team. The ideal candidate will be responsible for managing accounts receivable activities by following up with insurance companies to ensure timely and accurate reimbursement for healthcare claims. You will play a key role in identifying denials, resolving claim issues, and ensuring the financial success of our clients.Key Roles and Responsibilities:<ul><li>Perform follow-up calls with insurance companies (US Healthcare payers) to resolve outstanding claims.</li><li>Verify claim status, payment information, and identify reasons for delays or denials.</li><li>Analyze and resolve claim denials by taking appropriate action or escalating complex issues as required.</li><li>Work on denial management and appeals, ensuring timely submission and resolution.</li><li>Identify root causes of denials and share feedback for process improvement.</li><li>Maintain accurate documentation of all claim activities in the billing system.</li><li>Communicate effectively with insurance representatives and internal departments.</li><li>Achieve daily/weekly productivity targets and ensure adherence to quality standards.</li><li>Stay updated on payer policies, coding guidelines, and industry regulations.</li></ul>Required Skills &amp; Competencies:<ul><li>Minimum 2 years of experience as an AR Caller in US Healthcare (Medical Billing) domain.</li><li>Strong understanding of RCM process, insurance terminologies, CPT, ICD-10 codes, and EOBs.</li><li>Excellent verbal and written communication skills.</li><li>Strong analytical and problem-solving abilities.</li><li>Proficiency in using medical billing software and MS Office tools.</li><li>Ability to work independently and in a team within a fast-paced environment.</li><li>Flexibility to work night shifts (US time zone).</li></ul>Job Types: Full-time, PermanentPay: &#8377;200,000.00 - &#8377;300,000.00 per yearBenefits:<ul><li>Food provided</li><li>Health insurance</li><li>Provident Fund</li></ul>Work Location: In person

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