AR Specialist

Wise Medical Billing Support is seeking a diligent and organized AR Specialist to join our team, focusing on managing outstanding insurance claims for our U.S. healthcare clients. This role requires a persistent individual who can effectively handle follow-ups by phone and through payer portals to ensure timely payment of claims. The AR Specialist thoroughly reviews accounts receivable aging reports, prioritizes claims based on their age and value, and investigates denials by analyzing Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs). Working within an established shift from 6:00 PM to 3:00 AM (Pakistan Time), this position is ideal for a professional with a strong understanding of insurance claim processes and denial management, eager to contribute to improving revenue cycle outcomes. In this position, the AR Specialist will collaborate with the billing, coding, and credentialing departments to resolve issues impeding claim payments, ensuring compliance with healthcare regulations including HIPAA. The successful candidate must be fluent in English to communicate effectively with U.S. insurance payers. With a minimum of two years of experience in medical billing and AR follow-up, the AR Specialist is entrusted with reducing days in accounts receivable and improving collection rates. The role offers an opportunity to grow into senior roles within accounts receivable, quality assurance, or revenue cycle management based on performance.
Responsibilities

Review accounts receivable aging reports and prioritize outstanding insurance claims based on their age and dollar value.
Conduct timely follow-ups with U.S. insurance companies via phone and payer portals to address unpaid or underpaid claims.
Analyze Explanation of Benefits (EOB) and Electronic Remittance Advices (ERA) documents to identify claim denials and underpayments, determining the root cause of each issue.
Investigate and resolve claim rejections including eligibility, authorization, and coding discrepancies.
Prepare and file appeals as necessary and resubmit corrected claims to recover due reimbursements.
Coordinate with billing, coding, and credentialing teams to resolve issues blocking payment of claims.
Maintain accurate and detailed follow-up records and notes on each claim worked to support efficient tracking and resolution.
Work to reduce Days in Accounts Receivable (DAR) and improve the collection rates for assigned accounts.
Ensure strict compliance with HIPAA regulations and maintain confidentiality in all interactions related to patient data and insurance information.
Stay up-to-date with the latest payer rules and denial management strategies through structured onboarding and ongoing training.
Manage multiple accounts simultaneously with attention to detail and persistence until all claims are resolved.
Assist in preparing AR aging reports and collections performance data as required.
Support continuous improvement initiatives to streamline AR processes and increase recovery rates.