denial management specialist

Wonder Worth Solutions Pvt Ltd

<div><p><b>Job Summary :</b></p>
<p>
The AR/Denial Management Intern supports the team in tracking, analyzing, and documenting claim denials while gaining hands-on exposure to healthcare revenue cycle processes, insurance guidelines, and reimbursement workflows.</p>
<p><b>
Key Competencies:</b></p>
<ul>
<li>Denial Management Expertise</li>
<li>Leadership &amp; Team Development</li>
<li>Adaptability and Process Improvement</li>
<li>Problem-Solving and Critical Thinking.</li>
<li>Time Management</li>
<li>Identify, Analyze, and Resolve Denials</li>
<li>Ensure Accurate Submissions</li>
<li>Track and Categorize Denials</li>
<li>Investigate Denial Causes</li>
<li>Appeals and Negotiations</li>
<li>Monitor Denial Trends</li>
</ul>
<p><b>Qualifications:</b></p>
<ul>
<li>Education: Bachelor&rsquo;s degree in healthcare administration, business, or related field</li>
<li>Experience: Minimum of 2-3 years of experience in denial management, accounts receivable, or revenue cycle management in a healthcare</li>
</ul>
<p><b>Skills:</b></p>
<ul>
<li>Strong analytical and problem-solving</li>
<li>Excellent communication and interpersonal skills for dealing with insurance companies, healthcare providers, and team</li>
<li>Leadership experience and the ability to delegate tasks</li>
<li>High attention to detail with the ability to spot trends in denial data.</li>
<li>Ability to manage time effectively and prioritize tasks in a fast-paced</li>
</ul>
<p><b>Benefits:</b></p>
<ul>
<li>Competitive salary and benefits package</li>
<li>Opportunity to lead a team</li>
<li>Chance to make a real impact</li>
</ul>
<p><b>Contact us on recruiter@wonderws.com /vk.rmt@wonderws.com/ 9047477375.</b></p>
<p>
Note: &ldquo;This position is exclusively for Vellore-based candidates.&rdquo;</p>
<p><b>
 To Apply:</b>https://careers.wonderws.com</p></div>

L4- Chapter Leader ( AR Analyst )

eServMD Pvt. Ltd.

<p>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.</p><p>We are seeking experienced and detail-oriented A/R Specialists to join our team.</p><p><b>Responsibilities:</b></p><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><p><b>Job Specification:</b></p><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><p>Job Type: Full-time</p><p>Job Type: Full-time</p><p>Work Location: In person</p>

A/R Specialist (Medical Billing)

PYXIDIA TECHLAB LLP

<p><b>Job Description: AR Process Associate</b></p><p><b>Location:</b> Navi Mumbai, Turbhe</p><p><b>About the Role</b></p><p>We are seeking dedicated and experienced Accounts Receivable (AR) Callers to join our Navi Mumbai team. This crucial role within our Revenue Cycle Management (RCM) operations focuses specifically on managing and resolving outstanding claims within the <b>US healthcare sector</b>. The ideal candidate will be proficient in specific medical billing software, demonstrate expert knowledge of US healthcare guidelines, and maintain strict compliance with industry standards.</p><p><b>Key Responsibilities</b></p><p>&middot; <b>Claim Follow-Up and Resolution:</b> Proactively follow up with US-based medical insurance payers via phone regarding the status of outstanding claims to ensure timely reimbursement.</p><p>&middot; <b>Form Preparation &amp; Submission:</b> Accurately complete and send appropriate claim forms, adhering strictly to <b>US CMS</b>, <b>UB04</b>, <b>CMS-1500</b>, and third-party payer guidelines.</p><p>&middot; <b>Denial Management:</b> Utilize end-to-end process knowledge to manage, analyze, and resolve claim denials efficiently within the US healthcare framework.</p><p>&middot; <b>Compliance and Documentation:</b> Ensure all activities align with US healthcare regulations (e.g., <b>HIPAA</b>) and maintain meticulous documentation of all follow-up actions and communications within the billing system.</p><p>&middot; <b>Service Excellence:</b> Demonstrate a high level of professionalism and service excellence when interacting with all clients, employees, and US-based patient account details.</p><p><b>Required Qualifications &amp; Skills</b></p><p>&middot; <b>Experience:</b></p><p>o 1 to 2 years of proven experience in an AR calling role exclusively within the <b>US Healthcare Industry</b>.</p><p>o Specific, hands-on experience working with <b>Epic Software</b> is mandatory.</p><p>o Experience working with the <b>CMS-1500</b> process and US EOBs (Explanation of Benefits).</p><p>&middot; <b>Eligibility:</b></p><p>o Any Graduate degree is acceptable.</p><p>&middot; <b>Skills &amp; Knowledge:</b></p><p>o In-depth, end-to-end process knowledge of <b>Denial Management</b> relevant to US payers.</p><p>o Familiarity with US billing codes and guidelines.</p><p>o Strong communication and problem-solving skills with a professional command of English.</p><p>Job Types: Full-time, Permanent</p><p>Pay: ₹30,000.00 - ₹45,000.00 per month</p><p>Benefits:</p><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><p>Application Question(s):</p><ul><li>Are you currently residing in Navi Mumbai?</li><li>How many years of experience you have in AR?</li></ul><p>Work Location: In person</p>

Accounts Receivable Process Associate

EPIQ INDIA SUPPORT SERVICES LLP

<p><b>Job Title:</b> AR Caller &ndash; Medical Billing</p><p><b>Location:</b> Bangalore<br/><b>Experience:</b> 1&ndash;4 years<br/><b>Employment Type:</b> Full-time</p><p><b>Job Summary</b></p><p>We are looking for an experienced <b>AR Caller</b> to manage insurance follow-ups, resolve claim denials, and ensure timely reimbursement for medical billing accounts.</p><p><b>Key Responsibilities</b></p><ul><li>Follow up with US insurance companies on unpaid and denied claims</li><li>Analyze EOBs/ERAs and identify reasons for claim denials</li><li>Work on aging AR (30/60/90+ days) to ensure maximum collections</li><li>Correct and resubmit denied or underpaid claims</li><li>Communicate effectively with insurance representatives via calls and portals</li><li>Document all actions and updates accurately in billing systems</li><li>Meet daily productivity and quality benchmarks</li></ul><p><b>Required Skills</b></p><ul><li>Strong knowledge of <b>US medical billing and AR processes</b></li><li>Experience with insurance follow-ups and denial management</li><li>Familiarity with CPT, ICD-10, and HCPCS codes</li><li>Understanding of EOBs, ERA, and payer portals</li><li>Good communication and analytical skills</li></ul><p><b>Preferred Qualifications</b></p><ul><li>Graduation in any discipline</li><li>Experience with US healthcare processes</li><li>Knowledge of billing software and EMR systems is a plus</li></ul><p><b>Work Location</b></p><ul><li>Bangalore (On-site)</li></ul><p>Job Type: Full-time</p><p>Pay: ₹24,098.19 - ₹45,060.06 per month</p><p>Benefits:</p><ul><li>Food provided</li><li>Health insurance</li><li>Internet reimbursement</li><li>Leave encashment</li><li>Provident Fund</li></ul><p>Work Location: In person</p>

AR Caller

Ensemble Health Partners

<div><div>Thank you for considering a career at Ensemble Health Partners!</div><div></div><div>
Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.</div><div></div><div>
Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference!</div><div></div><div>
O.N.E Purpose:</div><ul><li><div>
Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.</div></li><li><div>
Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.</div></li><li><div>
Striving for Excellence: Execute at a high level by demonstrating our &ldquo;Best in KLAS&rdquo; Ensemble Difference Principles and consistently delivering outstanding results.</div></li></ul><div></div><div>
The Opportunity:</div><div></div><div>
CAREER OPPORTUNITY OFFERING</div><ul><li>
Bonus Incentives</li><li>
Paid Certifications</li><li>
Tuition Reimbursement</li><li>
Comprehensive Benefits</li><li>
Career Advancement</li><li>
This position pays between $16.50 - $21.35 /hr based on experience</li></ul><div></div><div>
The Denials Specialist is responsible for clinically related claim denials across Ensemble Health Partners. Job duties include, but are not limited to, contacting insurance plans to determine reasons claims were denied, analyzing the claims and determining if appeal is necessary, preparing the appeal materials which may include correcting and resubmitting claims, gathering additional information, including reviews of medical records, acting as a liaison between healthcare providers for any additional medical documentation or clarification and submitting appeals in a timely manner.</div><div></div><div>
Essential Job Functions:</div><ul><li>
Analyze claims, remittances, denial letters, and contact payers to effectively determine root causes for denials and steps to resolution</li></ul><ul><li>
Analyzing the claims and determining if appeal is necessary</li></ul><ul><li>
Preparing the appeal materials which may include correcting and resubmitting claims, gathering additional information, including reviews of medical records</li></ul><ul><li>
Acting as a liaison between healthcare providers for any additional medical documentation or clarification and submitting appeals in a timely manner</li></ul><ul><li>
Knowledgeable in Revenue Cycle terminology and processes; able to effectively triage denials for appropriate actions to be taken</li></ul><ul><li>
Meets quality and productivity standards - able to accurately type, format, and draft appeal letters</li></ul><div></div><div>
This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Associates may be required to perform other job-related duties as required by their supervisor, subject to reasonable accommodation.</div><div></div><div>
Job Experience:</div><div>
1 to 3 Years</div><div></div><div>
Education Level:</div><div>
Associate&rsquo;s degree or Equivalent Experience</div><div></div><div>
Knowledge, Skills and Abilities:</div><ul><li>
2 years of denials or accounts receivable</li><li>
Type 35 wpm</li><li>
Experience in hospital operations, chart audit/review, and provider relations</li></ul><div></div><div>
Join an award-winning company</div><div></div><div>
Five-time winner of &ldquo;Best in KLAS&rdquo; 2020-2022, 2024-2025</div><div>
Black Book Research's Top Revenue Cycle Management Outsourcing Solution 2021-2024</div><div>
22 Healthcare Financial Management Association (HFMA) MAP Awards for High Performance in Revenue Cycle 2019-2024</div><div>
Leader in Everest Group's RCM Operations PEAK Matrix Assessment 2024</div><div>
Clarivate Healthcare Business Insights (HBI) Revenue Cycle Awards for strong performance 2020, 2022-2023</div><div>
Energage Top Workplaces USA 2022-2024</div><div>
Fortune Media Best Workplaces in Healthcare 2024</div><div>
Monster Top Workplace for Remote Work 2024</div><div>
Great Place to Work certified 2023-2024</div><ul><li><div>
Innovation</div></li><li><div>
Work-Life Flexibility</div></li><li><div>
Leadership</div></li><li><div>
Purpose + Values</div></li></ul><div></div><div>
Bottom line, we believe in empowering people and giving them the tools and resources needed to thrive. A few of those include:</div><ul><li>
Associate Benefits &ndash; We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs.</li><li><div>
Our Culture &ndash; Ensemble is a place where associates can do their best work and be their best selves. We put people first, last and always. Our culture is rooted in collaboration, growth, and innovation.</div></li><li><div>
Growth &ndash; We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.</div></li><li><div>
Recognition &ndash; We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.</div></li></ul><div></div><div>
Ensemble Health Partners is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws. Ensemble Health Partners also prohibits harassment of applicants or employees based on any of these protected categories.</div><div></div><div>
Ensemble Health Partners provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law. If you require accommodation in the application process, please contact <div>TA@ensemblehp.com</div>.</div><div></div><div>
This posting addresses state specific requirements to provide pay transparency. Compensation decisions consider many job-related factors, including but not limited to geographic location; knowledge; skills; relevant experience; education; licensure; internal equity; time in position. A candidate entry rate of pay does not typically fall at the minimum or maximum of the role&rsquo;s range.</div><div></div><div><div>
EEOC &ndash; Know Your Rights</div><br>
<div>FMLA Rights - English</div></div><div><div>
La FMLA Espa&ntilde;ol</div></div><div><div>
E-Verify Participating Employer</div> (English and Spanish)</div><div><div>
Know your Rights</div></div></div>

Denials Specialist

Premier MBC

<p><b>Job Timing: </b>06:00 PM To 03:00 AM</p><p><b>Job Location:</b> Karachi Shahrah e Faisal</p><p><b>Job Description</b></p><p><b>PMBC </b>are US based Medical Billing Revenue Cycle Management Company. We are looking for enthusiastic and experienced Medical Billing Professionals with experience of working with US based Medical Billing Companies.</p><p>Prospect should have experience in Billing , AR , Denial Management , Appeals , Good Excel and reporting skills.</p><p><b>The Candidates should be meet the following Criteria in order to qualify for the job :</b></p><ul><li>Working on CPT/ICD coding</li><li>Review patient bills for accuracy and completeness and obtain any missing information</li><li>Knowledge of insurance guidelines especially Medicare and state Medicaid</li><li>Follow up on unpaid claims within standard billing cycle timeframe</li><li>Check each insurance payment is for accuracy and compliance with contract discount</li><li>Call insurance companies regarding any discrepancy in payments if necessary</li><li>Identify and bill secondary or tertiary insurances</li><li>All accounts are to be reviewed for insurance or patient follow-up</li><li>Answer patient or insurance telephone inquiries pertaining to assigned accounts.</li><li>To Communicate Effectively with Team and Clients.</li><li>To perform the Account Receivables, Denial Management, Appeal Management.</li><li>To maintain the protocols and documentation of each performed task.</li><li>Any other task as assigned by the management.</li><li>Strong verbal communication skills (English).</li></ul><p><b>Job Specification:</b></p><ul><li>Excellent working knowledge of EHR's &amp; Medical Billing Software's like CureMD , Kareo, Practice Fusion, MS Office, Web Fax (Metro Fax), Encoder pro, Payer Portals and other related tools and software&rsquo;s.</li><li>Good knowledge of Medical Billing and Coding</li><li>Denial management and Appeal</li><li>Authorization (Pre, Post, and Retro)</li><li>Research and Management Reporting</li><li>Must be a good team player</li><li>Strong verbal (English) and written communication (Good Typing speed).</li></ul><p><b>PMBC</b> provide a great career path and our employee are compensated with competitive compensation commensurate with their experience , Please let us know if you are in market to work as a <b>Senior A/R</b> Medical Billing <b>Specialist</b> . We prefer prospects seeking full time employment.</p><p><b>Experience:</b></p><p>3 - 5 years</p><p><b>Job Rewards and Benefits</b></p><ul><li>Paid Leaves</li><li>Medical</li><li>EOBI</li><li>Saturday and Sunday Off</li><li>Complementary Food (Dinner)</li></ul><p>Job Type: Full-time</p><p>Application Question(s):</p><ul><li>Do you have a degree?</li><li>Can you communicate in English?</li><li>How many years of experience you have in Medical Billing and RCM?</li><li>Can you work in night shifts?</li><li>what is your current salary?</li><li>What is your expected salary?</li></ul><p>Work Location: In person</p>

AR Executive (Karachi)

Macrise Tech Solutions

<p>We are seeking a highly organized and detail-oriented <b>Accounts Receivable &amp; Denials Resolution Specialist</b> to support our medical billing operations. In this role, you will be responsible for managing outstanding insurance claims, resolving denials, and ensuring accurate and timely reimbursement from payers. The ideal candidate is analytical, efficient, and capable of communicating professionally with patients, providers, and insurance representatives in a fast-paced healthcare environment.</p><p><b>Key ResponsibilitiesAccounts Receivable &amp; Denial Resolution</b></p><ul><li>Monitor, track, and manage outstanding insurance claims to reduce overall Accounts Receivable (AR).</li><li>Conduct daily follow-ups on denied claims to ensure timely and effective resolution.</li><li>Review Electronic Remittance Advice (ERA) reports to identify recurring denial trends and recommend preventive or corrective actions.</li><li>Prepare, submit, and track appeals for denied or underpaid claims, ensuring all supporting documentation is complete and accurate.</li><li>Investigate payment variances and escalate complex or unresolved issues to the Billing Manager as needed.</li><li>Maintain accurate AR aging reports and provide consistent weekly and monthly performance updates.</li><li>Process and manage claims related to specialized services, including TMS, Spravato, and psychological evaluations.</li><li>Collaborate closely with the Billing Manager to meet AR reduction, recovery, and accuracy targets.</li></ul><p><b>Patient &amp; Provider Coordination</b></p><ul><li>Respond promptly and professionally to billing inquiries from patients, providers, and internal departments.</li><li>Verify and update patient account details prior to initiating any collection activities.</li><li>Work with providers to correct claim errors, including coding inaccuracies and incomplete documentation.</li><li>Coordinate with insurance payers regarding eligibility verification, prior authorizations, and network participation.</li><li>Address patient concerns respectfully and process refunds when applicable.</li></ul><p><b>System &amp; Process Optimization</b></p><ul><li>Create, track, and resolve billing-related support tickets within eClinicalWorks (eCW).</li><li>Provide training and guidance to team members on AR and denial management workflows.</li><li>Coordinate with U.S.-based billing teams to ensure timely and accurate claim submissions.</li><li>Participate in performance review meetings, analyze trends, and recommend workflow and process improvements.</li><li>Stay current with payer policies, regulatory requirements, and evolving medical billing best practices.</li></ul><p>Job Type: Full-time</p><p>Pay: Rs45,000.00 - Rs70,000.00 per month</p><p>Ability to commute/relocate:</p><ul><li>Wapda Town: Reliably commute or planning to relocate before starting work (Required)</li></ul><p>Application Question(s):</p><ul><li>Willing to work as per US timing, Wapda Town, Lahore</li></ul><p>Experience:</p><ul><li>Medical Billing: 1 year (Preferred)</li></ul><p>Language:</p><ul><li>English (Required)</li></ul><p>Work Location: In person</p>

Medical Billing AR Executive

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