AR & Claims Follow-Up Specialist

XenMD is seeking a motivated and detail-oriented AR & Denial Management Executive to join our Medical Billing and Revenue Cycle Management team. The role involves managing outstanding insurance accounts receivable, following up on unpaid claims, identifying and resolving denials, submitting corrected claims and appeals, and maximizing collections for U.S.-based healthcare providers. The ideal candidate will have hands-on experience with U.S. medical billing, insurance follow-up, denial management, EOB/ERA analysis, and payer portals.

Key Responsibilities

Accounts Receivable Management: Manage assigned insurance AR and outstanding claims, including 30, 60, 90, and 120+ day AR. Follow up with insurance companies on unpaid and underpaid claims by contacting payers via phone and online portals. Identify delayed, rejected, unpaid, and partially paid claims while maintaining accurate follow-up notes and next-action dates. Prioritize high-value and aging claims to reduce outstanding AR and improve collections.

Denial Management: Review denied and rejected claims to identify root causes. Analyze EOBs, ERAs, rejection reports, and payer correspondence to determine if claims require correction, resubmission, reconsideration, or appeal. Prepare and submit corrected claims and appeals, follow up on previously submitted appeals, and identify recurring denial patterns to communicate with the billing and coding teams. Research payer policies as needed and escalate complex or high-value denials to management.

Insurance Follow-Up: Perform timely insurance follow-up according to established AR workflows. Communicate professionally with insurance representatives to obtain claim reference numbers, call documentation, payment information, and expected resolution dates. Verify claim processing, payment, denial, and adjustment details, following up until claims are paid, resolved, or escalated. Maintain detailed documentation of all payer interactions.

Claims & Billing Support: Review claims for common billing errors during denial investigations. Coordinate with charge entry, coding, credentialing, and billing teams to resolve claim issues. Assist with eligibility and benefits verification, identify missing information affecting claim processing, and support corrected claims and resubmissions. Monitor timely filing issues and escalate claims approaching deadlines.

Payer Experience: Experience with U.S. payers such as Medicare, Medicaid, Medicare Advantage, UnitedHealthcare, Aetna, Cigna, Humana, Blue Cross Blue Shield, Anthem/Elevance Health, and regional commercial insurance plans is preferred. Familiarity with payer portals like Availity, UHC, Aetna, Cigna, Medicare, Medicaid, and others is advantageous.

Required Qualifications

- 1–3+ years of experience in U.S. medical billing, accounts receivable, or denial management
- Strong understanding of the U.S. healthcare revenue cycle
- Hands-on experience with insurance claim follow-up and working denied, rejected, and unpaid claims
- Ability to read and interpret EOBs and ERAs
- Knowledge of corrected claims, reconsiderations, and appeals
- Familiarity with CPT, ICD-10, modifiers, and basic medical billing concepts
- Strong written and verbal communication skills
- Excellent attention to detail and ability to work independently managing multiple accounts
- Proficient computer and data-entry skills

Preferred Qualifications and Benefits

Experience with medical billing and revenue cycle management platforms such as Athenahealth, Tebra, AdvancedMD, Kareo, Office Ally, Claim.MD, Waystar, eClinicalWorks, and SimplePractice is a plus. Experience working across multiple specialties is also beneficial.

We offer a competitive salary based on experience, a professional and growth-oriented work environment, and opportunities to work with U.S.-based healthcare providers and insurance companies. Career growth, ongoing training, and professional development are supported. This role provides exposure to multiple specialties and payer types.

Job Details

Position: AR & Denial Management Executive
Location: Phase 7, Bahria Town, Rawalpindi
Employment Type: Full-Time
Shift: Night Shift
Department: Medical Billing / Revenue Cycle Management
Work Location: In person
Salary Range: Rs55,000 - Rs75,000 per month

Interested candidates are encouraged to apply through Indeed only by submitting an updated CV. Shortlisted applicants will be contacted for the next stage of the hiring process.