Medical Biller US Healthcare Claims & Collections (AR Follow-up/RCM) |Eastwood

Job Description – AR Analyst / Senior AR Analyst

Department: Revenue Cycle Management (RCM)
Location: Eastwood City Libis

Role Overview

The AR Analyst / Senior AR Analyst is responsible for managing accounts receivable, ensuring timely follow-ups on outstanding claims, resolving denials, and maximizing collections from insurance payers. The role involves handling both routine and complex AR scenarios, with senior-level expectations including denial analysis, escalations, and mentoring support.

Key Responsibilities

AR Follow-up & Collections

• Follow up with payers via calls, emails, fax, and portals to resolve outstanding claims.

• Work and prioritize accounts based on value, TAT, and payer guidelines.

• Ensure timely resolution of unpaid, denied, or partially paid claims.

Denial Management & Issue Resolution

• Analyze and resolve denials, rejections, underpayments, and overpayments.

• Initiate and manage appeals with proper documentation and supporting information.

• Identify and correct medical billing errors impacting claim payment.

• Handle complex denial scenarios and escalations.

Analysis & Process Improvement

• Perform analysis to identify trends in denials and payment delays.

• Conduct root cause analysis (RCA) for recurring issues.

• Recommend and support process improvements to reduce denials and increase collections.

System Utilization & Documentation

• Use workflow systems, client systems, and payer portals to manage accounts.

• Maintain accurate and complete documentation of all follow-ups and actions.

• Work independently on assigned work queues and ensure completion within TAT.

Compliance & Guidelines

• Adhere to payer guidelines, timely filing limits, and billing protocols.

• Ensure compliance with HIPAA and Information Security policies.

• Protect and use PHI appropriately, limiting access to minimum necessary.

Team Support & Collaboration (Senior Level)

• Provide guidance and support to junior team members.

• Collaborate with coding, billing, and quality teams for issue resolution.

• Communicate trends, risks, and escalations to management and stakeholders.

Additional Responsibilities

• Assist with special AR projects, reporting, and process initiatives.

• Maintain professionalism in interactions with patients, clients, and internal teams.

• Perform other duties as assigned by management.

Required Skills

• Strong knowledge of US Healthcare RCM (AR, denials, billing workflows)

• Understanding of EOB/ERA, CPT/ICD basics, and payer guidelines

• Analytical and problem-solving ability

• Effective communication and payer handling skills

• Ability to work independently and manage workload

• Strong expertise in denial management and complex AR scenarios