Accounts Receivable

1 day ago

Pune, Maharashtra, India Intelligentdx Full time ₹ 4,00,000 - ₹ 8,00,000 per year

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.
  • Strong 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 environment.
  • Demonstrates integrity, accountability, and professional behavior in all interactions.
  • Customer serviceoriented, empathetic, and adaptable.

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