Role & responsibilities
Perform AR follow-up for US Healthcare Provider-side accounts across Qualified 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 Skilled 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