Medical Biller US Healthcare Claims & Collections (AR Follow-up/RCM) |Eastwood

United States
Full Time
Experienced

Job Description – AR Analyst / Senior AR Analyst

Department: Revenue Cycle Management (RCM)
Location: Eastwood City Libis

Role Overview

The AR Analyst / Senior AR Analyst is responsible for managing accounts receivable, ensuring timely follow-ups on outstanding claims, resolving denials, and maximizing collections from insurance payers. The role involves handling both routine and complex AR scenarios, with senior-level expectations including denial analysis, escalations, and mentoring support.

Key Responsibilities

AR Follow-up & Collections

  • Follow up with payers via calls, emails, fax, and portals to resolve outstanding claims.

  • Work and prioritize accounts based on value, TAT, and payer guidelines.

  • Ensure timely resolution of unpaid, denied, or partially paid claims.

Denial Management & Issue Resolution

  • Analyze and resolve denials, rejections, underpayments, and overpayments.

  • Initiate and manage appeals with proper documentation and supporting information.

  • Identify and correct medical billing errors impacting claim payment.

  • Handle complex denial scenarios and escalations.

Analysis & Process Improvement

  • Perform analysis to identify trends in denials and payment delays.

  • Conduct root cause analysis (RCA) for recurring issues.

  • Recommend and support process improvements to reduce denials and increase collections.

System Utilization & Documentation

  • Use workflow systems, client systems, and payer portals to manage accounts.

  • Maintain accurate and complete documentation of all follow-ups and actions.

  • Work independently on assigned work queues and ensure completion within TAT.

Compliance & Guidelines

  • Adhere to payer guidelines, timely filing limits, and billing protocols.

  • Ensure compliance with HIPAA and Information Security policies.

  • Protect and use PHI appropriately, limiting access to minimum necessary.

Team Support & Collaboration (Senior Level)

  • Provide guidance and support to junior team members.

  • Collaborate with coding, billing, and quality teams for issue resolution.

  • Communicate trends, risks, and escalations to management and stakeholders.

Additional Responsibilities

  • Assist with special AR projects, reporting, and process initiatives.

  • Maintain professionalism in interactions with patients, clients, and internal teams.

  • Perform other duties as assigned by management.

Required Skills

  • Strong knowledge of US Healthcare RCM (AR, denials, billing workflows)

  • Understanding of EOB/ERA, CPT/ICD basics, and payer guidelines

  • Analytical and problem-solving ability

  • Effective communication and payer handling skills

  • Ability to work independently and manage workload

  • Strong expertise in denial management and complex AR scenarios

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