Job Title: AR Caller / AR Follow up (RCM) – Senior Executive

Job Type: Full-Time | Work Mode: Work from Office

Location: Gurugram, Sec 18

About the Position:

We are looking for an experienced AR Denials – Senior Executive with strong expertise in Accounts Receivable (AR) follow-up and Denial Management in the US Healthcare process. The ideal candidate should have a thorough understanding of denial codes and reasons such as No Authorization, Duplicate, Bundled, Inclusive, COB (Coordination of Benefits), and others.

The role requires working directly with insurance companies, healthcare providers, and patients to ensure timely resolution of claims and denial recovery while maintaining compliance with HIPAA standards.

Key Responsibilities:

Manage AR follow-up focusing on denial resolution and recovery
Analyze denials including No Auth, Duplicate, Bundled, Inclusive, COB, Non-Covered, Medical Necessity, Timely Filing, etc
Contact insurance companies to check claim status, understand denial reasons, and take corrective actions
Verify accurate insurance details and patient registration data on behalf of clients
Communicate with clients regarding potential coding, billing, or documentation issues
Submit claims via billing software (electronic and paper) and ensure accuracy in submissions
Follow up on unpaid or denied claims within the standard billing cycle timeframe
Research, resolve, and appeal denied or rejected claims with appropriate supporting documents
Perform eligibility and benefit verification through web portals or over the phone
Review patient bills for completeness and accuracy; obtain and rectify any missing information
Process payments including ERA (Electronic Remittance Advice) and EOB (Explanation of Benefits) posting
Understand and apply insurance payer policies including HMO, PPO, Medicare, Medicaid, and Commercial plans
Maintain accurate documentation of all actions in the system
Ensure compliance with HIPAA and internal quality standards

Required Skills & Qualifications:

Minimum 2 years of hands-on experience in US Healthcare AR follow-up and Denial Management
Strong understanding of denial types including No Auth, COB, Bundled, Duplicate, Inclusive, and other payer-specific denial reasons
Knowledge of payer rules, coordination of benefits (COB), and appeals processes
Familiarity with charge entry, claim submission, and payment posting (ERA/EOB)
Ability to read and interpret superbills and medical billing data
Strong verbal and written communication skills
Detail-oriented with the ability to multitask and meet productivity targets
Familiarity with credentialing is a plus
Proficient in handling Protected Health Information (PHI) in line with HIPAA compliance

Why Join Us

Be part of a collaborative and growing team
Competitive compensation and performance-based incentives
Opportunities for skill development in the healthcare RCM domain
Stable work environment with a focus on professional growth

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Onsite RCM Medical Biller (AR/Denials Management)