An Accounts Receivable (AR) Follow-up specialist at R1 RCM ensures healthcare providers (hospitals, physician practices, and health systems) receive timely and accurate reimbursement from US insurance companies and patients. The primary goal is to minimize unpaid claims, resolve claim denials, and manage aged accounts receivable.

Core Responsibilities

Payer Tracking & Follow-up: Reach out directly to insurance companies via phone or online web portals to track the real-time status of submitted, unpaid, or pending healthcare claims.

Denial Management & Resolution: Analyze unpaid or rejected claims by reviewing Explanation of Advantages (EOB) and Electronic Remittance Advice (ERA) to identify denial reasons. Fix errors (e.g., coding mistakes, patient eligibility issues, pre-authorization gaps) and resubmit claims promptly.

Appeals Processing: Draft and submit formal written appeals along with necessary medical documentation to contest improper claim rejections or partial payments.

Patient AR Support: Handle inquiries regarding billing discrepancies, outstanding copays/deductibles,



and resolve payment or credit balance issues.

Documentation & Compliance: Log detailed notes of all payer and patient interactions in the system to ensure compliance with HIPAA guidelines and standard operating procedures.

Key Skills & Requirements

Knowledge Base: Robust understanding of US Healthcare Revenue Cycle Management (RCM), medical billing practices, ICD-10/CPT coding, and insurance denial codes.

Communication: Excellent verbal and written English communication for negotiating with US insurance representatives and handling sensitive billing matters.

Analytical Aptitude: Ability to read EOB statements, pinpoint root causes of unpaid claims, and execute corrective action quickly.

Work Workplace: Shifts typically align with US business hours (Night Shifts for India-based delivery centers), and performance is evaluated on target metrics like resolved claim volumes and daily processing speed.

📌 Accounts Receivable Follow Up Associate Gurugram
🏢 R1 RCM
📍 Gurugram