Senior AR Specialist / AR Caller US Healthcare Physician Billing | Cardiology | Permanent WFH

Job Type: Full-Time

Work Mode: Permanent Work From Home

Openings: 1

Joining Requirement: Immediate Joiner Preferred

Industry: US Healthcare – Medical Billing / Revenue Cycle Management

Process: Physician Billing – Cardiology

Location: Remote / Work From Home

Job Summary

We are looking for an experienced and highly capable AR Specialist / AR Caller with strong hands-on experience in US Healthcare Physician Billing.

The selected candidate will be responsible for managing the Accounts Receivable inventory for a Texas-based Cardiology physician practice consisting of three Cardiologists.

The physicians provide services both in their outpatient clinic and across multiple hospitals. Professional charges for hospital services are billed through the physician practice using CMS-1500 claims.

This is not a basic AR calling position. We are looking for someone who can independently analyze and work the complete AR inventory, identify root causes for non-payment, resolve complex denials, reduce aging, prevent recurring issues, and improve overall collections.

The candidate should also have a strong understanding of the complete Physician Revenue Cycle, including eligibility, authorization, charge entry, coding concepts, claim submission, payment posting, denials, appeals, insurance follow-up, patient responsibility, and AR management.

Key Responsibilities

- Independently manage and work Physician Billing Accounts Receivable.
- Review and prioritize AR based on:

- Aging

- Dollar value

- Payer

- Denial reason

- Timely filing limits

- Appeal deadlines

- Collection potential
- Perform detailed claim-level follow-up with insurance payers.
- Identify the actual root cause of unpaid, underpaid, rejected, or denied claims.

- Work denials involving

- Eligibility and coverage
- Authorization / Pre-certification

- Medical necessity

- Coding and modifier issues
- Bundling / NCCI-related issues

- Global surgery

- Duplicate claims

- Coordination of Benefits

- Provider enrollment / credentialing
- Out-of-network issues

- Timely filing
- Maximum benefit / frequency limitations
- Missing or invalid claim information

- Medical records requests

- Underpayments
- Other payer-specific issues
- Review EOBs and ERAs and understand CARC/RARC denial and adjustment codes.
- Submit corrected claims, reconsiderations and appeals when required.




- Follow up through payer portals, clearinghouses and telephone calls.
- Perform appropriate documentation of every AR follow-up.
- Identify recurring denial trends and escalate operational issues to management.
- Work aggressively on aging accounts, particularly older and high-dollar AR.
- Develop appropriate follow-up strategies to maximize collections.
- Maintain timely and accurate follow-up schedules.
- Coordinate with Coding, Billing, Authorization, VOB, Payment Posting and other RCM teams whenever required.
- Identify issues originating from upstream processes and provide feedback to prevent repeat denials.
- Ensure timely filing and appeal deadlines are protected.
- Support management in achieving the primary goals of:

- Reducing AR Aging

- Increasing Insurance Collections

- Reducing Avoidable Denials
- Improving AR Resolution Turnaround Time

Practice & Billing Environment The candidate will be supporting a Texas-based Cardiology physician practice with three Cardiologists. The physicians provide services at the Cardiology clinic as well as approximately four hospitals, where professional services are billed through the practice using CMS-1500 claims.

The practice bills a wide range of Cardiology-related services, including:

- Office Visits / E&M;
- Hospital E&M; Services
- Echocardiography
- Holter Monitoring
- MCOT / Cardiac Monitoring
- Office-Based Lab (OBL) Services
- CTA
- CCM
- RPM
- Diagnostic Cardiology Services
- Procedures and other Cardiology-related professional services

Major Payers Candidates with experience handling Texas payers will be strongly preferred, particularly:

- Medicare
- Texas Medicaid
- WellMed
- UnitedHealthcare / UHC
- BCBS of Texas
- Humana
- Cigna
- Medicare Advantage Plans
- Commercial Insurance Plans
- Managed Care Plans
- Other Texas-based payers

Required Experience & Skills

- Strong hands-on experience in US Healthcare Physician Billing Accounts Receivable.
- In-depth knowledge of the complete Physician RCM Cycle.
- Strong understanding of CMS-1500 professional claim billing.




- Strong experience in insurance AR follow-up and denial management.
- Ability to independently analyze complex unpaid and denied claims.
- Robust understanding of EOBs, ERAs, CARC and RARC codes.
- Knowledge of Medicare, Medicaid, Medicare Advantage and Commercial insurance.
- Experience handling payer portals and insurance telephone follow-ups.
- Knowledge of corrected claims, reconsiderations and appeals.
- Understanding of CPT, ICD-10, modifiers and basic medical coding concepts relevant to AR follow-up.
- Ability to identify root causes instead of repeatedly following up without resolution.
- Ability to prioritize high-dollar and aging AR effectively.
- Strong analytical and problem-solving skills.
- Good written and verbal communication skills.
- Strong documentation and follow-up discipline.
- Ability to work independently in a permanent WFH environment.

Preferred Experience Candidates will receive additional preference if they have:

- Previous experience in Cardiology Physician Billing
- Experience with Texas payers
- Experience with WellMed
- Experience handling professional claims for hospital-based physician services
- Experience handling Cardiology procedures and diagnostic services
- Experience with CCM/RPM billing
- Experience handling high-volume or complex AR inventories
- Experience identifying denial trends and root causes
- Experience working independently with minimal supervision

Work From Home Requirements This is a Permanent Work From Home position.

The candidate must

- Own a reliable Laptop/Desktop with good configuration.
- Have a stable high-speed broadband internet connection.
- Have a professional and distraction-free work environment.
- Be able to work reliably during the assigned shift.
- Have a backup plan for internet/power interruptions wherever possible.

Joining Requirement Immediate joiners are strongly preferred.

Candidates with long notice periods may not be considered for this opening.

Who We Are Looking For

We are specifically looking for a candidate who does more than simply make payer calls.

The ideal candidate should be able to look at an AR account and determine:

Why is this claim unpaid?

What caused the issue?

What is the correct next action?

Can the claim still be collected?

How can we prevent the same issue from recurring?

The candidate should be capable of taking ownership of the AR inventory and contributing directly toward reducing aging and increasing collections.

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