Position Summary:

The Accounts Receivable (AR) Specialist is responsible for managing the full cycle of the medical claims follow-up and collections process. This role requires a detail-oriented and analytical professional who ensures timely reimbursement by effectively resolving unpaid or denied claims. The ideal candidate will have at least 4 years of hands-on experience in medical AR, strong knowledge of payer requirements, and proficiency in identifying and resolving claim issues to optimize revenue recovery.

Essential Functions:

To perform this job successfully, an individual must be able to perform each essential function satisfactorily. Responsible for all aspects of AR follow-up and collections, including making phone calls, sending correspondence, and accessing payer websites.

- Identify trends and perform root cause analysis on unpaid and underpaid claims.
- Research, appeal, and resolve claim rejections, denials, and underpayments with appropriate insurance payers.
- Initiate phone or written communication with patients to obtain missing or additional information as required.
- Accurately document all collection and follow-up activity in the system.
- Develop and maintain positive working relationships with clinical staff, internal teams, and payer representatives.
- Maintain professionalism and adhere to company policies in appearance, communication, and conduct.
- Meet deadlines,



manage priorities, and keep the supervisor informed about progress and issues.
- Ensure compliance with HIPAA, OSHA, and all applicable State and Federal regulations.
- Perform other related duties as assigned by management.

Qualifications:

Required:

- Minimum 4 years of experience in Accounts Receivable / Medical Billing and Collections.
- Strong operational knowledge of healthcare RCM processes, payer portals, and insurance claim workflows.

Preferred:

- Any Graduate
- Proficiency in MS Office Suite (Excel, Word, Outlook).

Certifications (Preferred):

- AHIMA or AAPC Certified Coding Specialist (CCS) or Certified Professional Coder (CPC).

Knowledge, Skills & Abilities:

- Strong understanding of HMO/PPO, Medicare, Medicaid, and other payer guidelines.
- Working knowledge of HCPCS, CPT, and ICD-10 coding.
- Excellent analytical and problem-solving skills with the ability to perform root cause analysis.
- Robust communication and negotiation skills when interacting with payers and patients.
- Highly organized, detail-oriented, and results-driven.
- Ability to work independently and manage multiple priorities in a fast-paced setting.
- Demonstrates integrity, accountability, and professional behavior in all interactions.
- Customer serviceoriented, empathetic, and adaptable.

📌 Accounts Receivable (AR) Specialist (Pune)
🏢 IntelligentDX
📍 Pune