About the Role
We are seeking skilled AR Follow-up and Denial Management Executives with hands-on experience in U.S. Healthcare RCM. The ideal candidate will be responsible for analyzing denied claims, following up with insurance companies, resolving payment issues, and ensuring timely reimbursement.
Key Responsibilities
- Perform AR follow-up with insurance carriers to resolve unpaid or underpaid claims.
- Handle denial management by identifying root causes, correcting claim issues, and ensuring reprocessing.
- Review and analyze claim denials (technical, clinical, and administrative).
- Document all actions taken on claims within the system accurately and promptly.
- Communicate efficiently with payers to obtain claim status and required clarifications.
- Work closely with internal billing/coding teams to prevent recurring denials.
- Meet daily/weekly productivity and quality benchmarks.
Required Skills & Qualifications
- 13 years of experience specifically in Denial Management and AR Follow-up within the U.S. healthcare RCM domain.
- Strong understanding of denial codes, EOBs, and insurance guidelines.
- Good communication skills (verbal and written).
- Ability to analyze issues and resolve claims efficiently.
- Proficiency in RCM tools, billing software, and MS Office (preferred).
Exclusions
- Candidates from general AR or accounting backgrounds are not eligible (e.g., O2C / OTC profiles from Genpact or similar companies).
- Only candidates with specific RCM-denial and AR follow-up experience should apply.
Why Join Us
- Opportunity to work with a growing RCM team.
- Skill development in core denial management and AR processes.
- Collaborative work environment with performance-based growth
