Sr.AR. Associate

MedConverge Healthcare Services PVT LTD.; India; On-site; INR 550,000 - 900,000; Full time

Job summary

MedConverge Healthcare Services PVT LTD. is seeking an experienced Senior AR Executive to join our Revenue Cycle Management team in India. You will manage insurance follow-ups, handle denials, reduce aging AR, and improve collections performance while ensuring HIPAA compliance.

The ideal candidate has 3–6 years in US healthcare AR/denial management, strong knowledge of payer guidelines, and proficiency in EOB/ERA interpretation. Night shifts and office-based work are required.

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).

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

US Healthcare AR / Denial Management

Insurance follow-ups

Payer guidelines knowledge

EOB/ERA interpretation

Analysis and communication

Night shift ability

Tools

Microsoft 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.