Role & responsibilities

- Perform AR follow-up for US Healthcare Provider-side accounts across Professional Billing (PB) and/or Hospital Billing (HB).
- Review aging reports, outstanding balances, and unpaid claims.
- Conduct insurance/payer follow-up through payer portals and phone calls.
- Identify reasons for non-payment, underpayment, rejection, or denial and take appropriate action.
- Handle claim status checks, payment issues, authorization-related issues, eligibility issues, and payer-related discrepancies.
- Analyze EOBs/ERAs to identify payment, denial, adjustment, and patient responsibility details.
- Follow up on underpaid and incorrectly paid claims and initiate appropriate action.
- Work on timely filing, medical necessity, authorization, coding-related, eligibility, and other payer denial categories.
- Prepare and submit appropriate appeals and reconsiderations for eligible denied claims.
- Identify recurring denial trends and communicate them to the relevant team.
- Maintain accurate AR account notes and follow-up documentation.
- Prioritize accounts based on aging, balance, payer, denial reason, and recovery potential.
- Meet defined productivity, quality, collections, and turnaround-time targets.




- Coordinate with Billing, Coding, Payment Posting, Charge Entry, and other RCM teams.
- Ensure proper follow-up on accounts until resolution or appropriate disposition.

Preferred candidate profile

- 2+ years of hands-on experience in US Healthcare Provider-side Accounts Receivable (AR).
- Practical experience in Professional Billing (PB) and/or Hospital Billing (HB).
- Solid knowledge of insurance/payer AR follow-up and claim status verification.
- Experience in denial and rejection management.
- Knowledge of EOB/ERA and payment, denial, adjustment, and patient responsibility details.
- Experience with insurance portals and payer calling/voice process.
- Knowledge of appeals and reconsiderations.
- Good understanding of AR aging, timely filing, authorization, eligibility, medical necessity, and coding-related denials.
- Good communication and documentation skills.
- Ability to work according to US Healthcare RCM processes and client-specific SOPs.

Experience: 2+ Years

Location: Pune / Ahmedabad

Employment Type: Full-Time (Work from office)

📌 We Are Hiring | AR Specialist | US RCM Healthcare (Ahmedabad)
🏢 NexCen IT Services
📍 Ahmedabad