AR Executive – RCM Process

Job Summary

Manage U.S. healthcare accounts receivable, claim follow-up, denial resolution and payment posting with clear documentation and ownership.

Responsibilities

• Re-submit corrected claims electronically or manually to Medicare, Medicaid and commercial carriers.
• Follow up on unpaid or denied claims through payer calls and online portals.
• Analyse and resolve claim rejections, denials and underpayments.
• Post insurance and patient payments accurately from ERA, EOB and patient-payment records.
• Maintain ageing reports and keep accounts receivable within target levels.
• Document activity, next actions and payer communication in the billing system.
• Coordinate with payers, patients and internal departments to resolve billing issues.
• Support month-end reconciliation and reporting as required.

Requirements & Qualifications

• At least two years of U.S. healthcare accounts-receivable experience.
• Strong understanding of Medicare, Medicaid, PPO, HMO and Workers’ Compensation insurance.
• Experience with medical billing software and payer or clearinghouse portals.
• Excellent written and verbal communication skills.
• Detail-oriented analytical and problem-solving ability.
• Working understanding of HIPAA and healthcare compliance requirements.

Nice to Have

• Experience with Epic; Athenahealth, eClinicalWorks, Kareo or AdvancedMD familiarity is also useful.
• Familiarity with CPT, ICD-10 and HCPCS coding.
• Knowledge of payer-specific guidelines and A/R best practices.