AR/RCM Specialist: Denials & Payer Appeals Expert

Infinit-O; Pasay; On-site; PHP 391,000 - 725,000; Full time

Job summary

Infinit-O is seeking an Accounts Receivable Specialist to actively manage collection of outstanding claims and resolve payment denials. This role directly impacts client cash flow and revenue realization by ensuring legitimate claims are paid quickly and accurately.

You will follow up on aging claims, analyze EOBs and RA, prepare appeals, contact payers, review underpayments, and document trends to drive process improvements across our US healthcare clients.

Qualifications

• 2-3 years of dedicated experience in Accounts Receivable follow-up and denial management within US Healthcare RCM.
• Proficient with payer portals (e.g., Availity, Navinet) for claims status and eligibility.
• Strong written and verbal communication skills for payer negotiations and appeals drafting.

Responsibilities

• A/R Follow-Up: Review and follow up on aging insurance claims.
• Denial Analysis & Resolution: Analyze EOBs/RA and denial codes for root causes.
• Appeals Management: Prepare and submit appeals with supporting documentation.
• Payer Communication: Contact payers to check status, challenge underpayments, negotiate resolutions.
• Underpayment Review: Identify underpayments and recover differences.
• Trend Identification: Document denial trends and payer process changes for improvements.

Skills

A/R Follow-Up

Denial Analysis

Appeals Management

Payer Communication

Underpayment Review

Trend Identification

Education

High School Diploma or equivalent

Associate's or Bachelor's degree preferred

Tools

Availity

Navinet

RCM/Practice Management Systems

Job description

Infinit-O is seeking an Accounts Receivable Specialist to actively manage collection of outstanding claims and resolve payment denials. This role directly impacts client cash flow and revenue realization by ensuring legitimate claims are paid quickly and accurately.

You will follow up on aging claims, analyze EOBs and RA, prepare appeals, contact payers, review underpayments, and document trends to drive process improvements across our US healthcare clients.