Accounts Executive – Medical Billing

We are seeking a detail-oriented and experienced Accounts Executive specializing in Medical Billing to join our Revenue Cycle Management (RCM) team. This role supports US-based healthcare operations and requires hands-on experience with US medical billing processes, insurance claims, accounts receivable (AR), denial management, payment posting, and insurance follow-up. The successful candidate will be responsible for managing assigned billing and AR activities, identifying and resolving claim issues, following up with insurance payers, handling denials and outstanding balances, and maintaining accurate billing documentation. A strong understanding of the US healthcare revenue cycle, excellent attention to detail, effective communication skills, and the ability to manage multiple priorities while meeting productivity and accuracy standards are essential.

Key Responsibilities

- Submit, review, and follow up on US healthcare insurance claims to ensure timely processing.
- Manage assigned accounts receivable and aged AR to optimize cash flow.
- Conduct follow-ups with insurance companies regarding unpaid, denied, and underpaid claims.
- Review Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs) to identify payment discrepancies and denial reasons.
- Correct and resubmit rejected or denied claims when appropriate to maximize reimbursement.
- Assist with insurance appeals and reconsiderations to resolve claim disputes.
- Perform payment posting and account reconciliation as assigned to maintain accurate financial records.
- Maintain detailed documentation of payer follow-up activities and account status.
- Identify recurring billing and denial issues and escalate them to the appropriate teams for resolution.
- Prepare and maintain reports related to accounts receivable, denials, and billing performance.
- Collaborate with internal billing, clinical, credentialing, and operations teams to resolve claim-related issues efficiently.
- Adhere to company procedures and comply with applicable US healthcare billing and regulatory requirements.

Required Qualifications

- Minimum of 1 year of experience in US medical billing or healthcare revenue cycle management.
- Strong knowledge of US insurance claims processes, accounts receivable management, denials, and payer follow-up procedures.
- Familiarity with CPT, HCPCS, ICD-10 coding, EOB/ERA documents, and basic medical billing terminology.
- Experience working with commercial insurance and/or government payers is preferred.
- Excellent English communication and documentation skills to ensure clear and accurate correspondence.
- Strong analytical, organizational, and problem-solving abilities to handle complex billing issues.
- Proficiency in Microsoft Excel and standard office applications for reporting and data management.
- Willingness and ability to work shifts aligned with US time zones, including night shifts.

Preferred Qualifications and Additional Information

Experience in behavioral health, psychiatry, mental health, or other outpatient healthcare billing will be considered an advantage.

Compensation
The position offers a starting salary from Rs 60,000 per month.

Education
Intermediate level education is required.

Language
Proficiency in English is mandatory.

Location and Work Arrangement
This role is based in Karachi and requires in-person attendance. Candidates must be willing to work night shifts as per US time zones.