AR Caller / AR Follow up (RCM) – Senior Executive

1 Month ago • 2 Years + • Software Development & Engineering

Job Summary

Job Description

We are seeking an experienced AR Denials – Senior Executive with strong expertise in Accounts Receivable (AR) follow-up and Denial Management within the US Healthcare process. The role involves working with insurance companies, healthcare providers, and patients to resolve claims and recover denials, ensuring HIPAA compliance. Key responsibilities include managing AR follow-up, analyzing various denial types like No Auth, Duplicate, Bundled, Inclusive, and COB, contacting insurance companies for claim status and corrective actions, verifying insurance and patient data, and submitting claims accurately. The position also requires processing payments, understanding insurance payer policies, maintaining documentation, and ensuring HIPAA compliance.
Must have:
  • Minimum 2 years US Healthcare AR follow-up experience
  • Strong understanding of denial types (No Auth, COB, Bundled, Duplicate, Inclusive)
  • Knowledge of payer rules and appeals processes
  • Familiarity with charge entry and claim submission
  • Strong communication skills
  • Detail-oriented and ability to multitask
  • Proficient in HIPAA compliance
Good to have:
  • Familiarity with payment posting (ERA/EOB)
  • Ability to read superbills and medical billing data
  • Familiarity with credentialing
Perks:
  • Collaborative and growing team
  • Competitive compensation and incentives
  • Opportunities for skill development
  • Stable work environment

Job Details

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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