AR Analyst
- Analyze and Prioritize: Critically review patient and insurance aging reports to pinpoint and prioritize high-value and long-pending outstanding claims.
- Investigate and Diagnose: Thoroughly investigate claim issues including denials, rejections, underpayments, and complex unpaid balances to determine the precise root cause.
- Action Planning: Develop and articulate clear, actionable follow-up plans and work closely with AR callers to ensure efficient resolution.
- Execute Corrections: Initiate required claim corrections, billing adjustments, or re submissions to expedite payment.
- Inter-Departmental Communication: Collaborate effectively with internal teams to resolve missing documentation, coding errors, or billing discrepancies.
- Documentation and Compliance: Ensure all actions, findings, and resolutions are accurately and compliantly documented in the billing system.
- Policy Monitoring: Continuously review and apply payer policies, fee schedules, and guideline updates to minimize future payment variance.
- Performance Metrics: Consistently meet daily/weekly targets related to quality, productivity, and turnaround time (TAT).
- Strategic Reporting: Support denial management by contributing to trending analysis and reporting to drive process improvement and enhance overall A/R performance.
- Experience: 1–4 years of demonstrated experience in U.S. Healthcare AR, Denial Management, or RCM roles. (Candidates with strong analytical skills and a desire to learn may be considered).
- Education: Any graduate or diploma holder.
- RCM Expertise: Strong conceptual understanding of the insurance claim lifecycle, processing guidelines, and standard denial codes (CARC/RARC).
- Technical Interpretation: Proven ability to accurately interpret EOBs (Explanation of Benefits) and ERA files to reconcile payments.
- Core Competency: Excellent analytical, logical reasoning, and investigative skills.
- Communication: Good written and verbal communication skills for clear internal and external correspondence.
- Tool Proficiency: Familiarity with major billing platforms (e.g., Kareo, Athena, NextGen, AdvancedMD, eCW) is a strong advantage. Proficiency in spreadsheets for basic reporting is preferred.
- Logical Reasoning and Problem-Solving
- Attention to Detail and Accuracy
- Accountability and Ownership
- Time Management and Prioritization
- Process-Oriented Mindset
- Team Collaboration
- Shift Timings: Day & Night Shift
- Work Schedule: Sunday & Monday off for day shift, Saturday & Sunday off for night shift (schedule may vary slightly based on client requirements).