Sr.AR. Associate

MedConverge LLC; Hyderabad; On-site; INR 500,000 - 800,000; Full time

Job summary

MedConverge LLC in Hyderabad is seeking an experienced Senior AR Executive to strengthen our Revenue Cycle Management team. You will perform insurance follow-ups, manage denials, and reduce aging AR while improving collections performance.

The ideal candidate understands payer guidelines, denial codes, and AR metrics, and can draft strong appeals. Night shifts and office-based work are required.

Qualifications

• 3–6 years of experience in US Healthcare AR / Denial Management.
• Knowledge of Medicare, Medicaid, and Commercial insurance.
• Expertise in EOB/ERA interpretation and managed care guidelines.
• Knowledge of Timely Filing Limits (TFL) and appeals process.
• Proficiency in Microsoft Office Suite (Excel preferred).
• Excellent communication and analytical skills.
• Strong attention to detail and ability to handle escalations independently.
• Ability to work night shifts and from the office.

Responsibilities

• Perform insurance follow-ups on unpaid, underpaid, and denied claims.
• Work on aging buckets (60+/90+/120+ AR) and reduce outstanding balances.
• Analyze denial codes (CO-97, CO-45, CO-18, CO-50, CO-197) and take appropriate action (Appeal / Rebill / Adjustment).
• Draft and submit strong appeals with required documentation.
• Follow up on high-value and escalated accounts.
• Interpret EOBs/ERAs accurately and identify payment discrepancies.
• Ensure timely filing compliance and adherence to payer guidelines.
• Accurately document call notes and account updates in the system.
• Coordinate with Posting, Coding, and Eligibility teams for issue resolution.
• Maintain productivity and quality standards as per SLA.
• Adhere to HIPAA regulations and company policies.
• Stay updated on payer updates and industry regulations.

Skills

AR Denial Mgmt

Payer Guidelines

EOB/ERA Interpretation

HIPAA Compliance

Night Shifts

MS Excel

Tools

MS Excel

Job description

We are seeking an experienced and performance-driven Senior AR Executive to join our Revenue Cycle Management team. This role involves handling insurance follow-ups, resolving denials, reducing aging accounts, and improving collections performance.

The ideal candidate will have strong knowledge of payer guidelines, denial management, and AR metrics such as Days in AR, Denial Resolution Rate, and Collection Effectiveness.

Key Responsibilities

• Perform insurance follow-ups on unpaid, underpaid, and denied claims.
• Work on aging buckets (60+/90+/120+ AR) and reduce outstanding balances.
• Analyze denial codes (CO-97, CO-45, CO-18, CO-50, CO-197) and take appropriate action (Appeal / Rebill / Adjustment).
• Draft and submit strong appeals with required documentation.
• Follow up on high-value and escalated accounts.
• Interpret EOBs/ERAs accurately and identify payment discrepancies.
• Ensure timely filing compliance and adherence to payer guidelines.
• Accurately document call notes and account updates in the system.
• Coordinate with Posting, Coding, and Eligibility teams for issue resolution.
• Maintain productivity and quality standards as per SLA.
• Adhere to HIPAA regulations and company policies.
• Stay updated on payer updates and industry regulations.

Qualifications

• 3–6 years of experience in US Healthcare AR / Denial Management.
• Strong understanding of Medicare, Medicaid, and Commercial insurance.
• Expertise in EOB/ERA interpretation and managed care guidelines.
• Knowledge of Timely Filing Limits (TFL) and appeals process.
• Proficiency in Microsoft Office Suite (Excel preferred).
• Excellent communication and analytical skills.
• Strong attention to detail and ability to handle escalations independently.
• Ability to work night shifts and from the office.