AR Caller AR Follow up RCM Senior Executive

Role Overview We are seeking an experienced AR Denials Senior Executive to manage Accounts Receivable follow-up and denial management in the US Healthcare sector. The ideal candidate will have strong expertise in handling various denial codes and reasons while working directly with insurance companies and healthcare providers. This role requires a thorough understanding of denial resolution processes and HIPAA compliance standards. Key Responsibilities - Manage AR follow-up with focus on denial resolution and recovery from insurance companies - Analyze and categorize denials including No Authorization, Duplicate, Bundled, Inclusive, COB, Non-Covered, Medical Necessity, and Timely Filing issues - Contact insurance companies to verify claim status, understand denial reasons, and implement corrective actions - Verify accurate insurance details and patient registration data on behalf of clients - Submit claims via billing software both electronically and in paper format while ensuring submission accuracy - Research, resolve, and appeal denied or rejected claims with appropriate supporting documentation - Perform eligibility and benefit verification through web portals and telephone inquiries - Process payments including ERA and EOB posting while maintaining accurate system documentation - Review patient bills for completeness and accuracy while obtaining missing information - Communicate with clients regarding potential coding, billing, or documentation issues - Understand and apply insurance payer policies including HMO, PPO, Medicare, Medicaid, and Commercial plans - Ensure compliance with HIPAA standards and internal quality requirements Required Qualifications - Minimum 2 years of hands-on experience in US Healthcare AR follow-up and Denial Management - Strong understanding of denial types and payer-specific denial reasons - Knowledge of payer rules, coordination of benefits, and appeals processes - Familiarity with charge entry, claim submission, and payment posting procedures - Ability to read and interpret superbills and medical billing data - Strong verbal and written communication skills in English - Detail-oriented with ability to multitask and meet productivity targets - Proficiency in handling Protected Health Information in compliance with HIPAA - Any graduate or postgraduate degree Why Join Us Be part of a collaborative and growing team with opportunities for skill development in the healthcare RCM domain. Enjoy competitive compensation with performance-based incentives and a stable work environment focused on professional growth.

- 2 years minimum US Healthcare AR follow-up and Denial Management experience - Strong understanding of denial codes and types - Knowledge of payer rules and appeals processes - Experience with claim submission and payment posting - Ability to interpret superbills and medical billing data - Excellent verbal and written communication skills - Detail-oriented and able to multitask - HIPAA compliance knowledge - Familiarity with credentialing preferred - Any graduate or postgraduate qualification

- Competitive compensation package - Performance-based incentives - Skill development opportunities in healthcare RCM - Stable work environment - Professional growth opportunities - Work from office in Sector 18, Gurugram