Senior AR Executive

Appedology Inc.; Islamabad; On-site; PKR 670,000 - 893,000; Full time

Benefits offered by this job

Medical Insurance

Provident Fund

Job summary

Appedology Inc. is seeking a Senior AR Executive to oversee the accounts receivable process for health insurance claims.

The role focuses on claims follow-up with insurers and patients, handling denials and appeals, and ensuring accurate, timely payment resolution. You will stay abreast of carrier rules and regulatory updates, resolve discrepancies, and maintain precise patient files while collaborating with the finance team to optimize the AR process.

Qualifications

• Experience in AR management for health insurance claims.
• Knowledge of payer websites, denials, and appeals processes.
• Familiarity with insurance carrier rules and government/commercial updates.

Responsibilities

• Oversee accounts receivable process for health insurance claims with insurers and patients.
• Follow up on claims to ensure timely resolution of payments.
• Handle claim denials and appeals with proper documentation.
• Stay updated on insurer rules, regulations, and billing procedures.
• Resolve payment discrepancies by researching with payers and patients.
• Maintain and update customer files in the system.
• Review EOB statements and explain them to patients and teams as needed.
• Re-submit claims when required to ensure accurate billing.

Skills

Accounts Receivable Mgmt

Insurance Claims Follow-Up

Regulatory Knowledge

EOB Explanation

Job description

The Senior AR Executive will oversee the entire accounts receivable process, specifically focused on health insurance claims. This includes managing claims follow-ups with insurance companies and patients, handling denials and appeals, and ensuring accurate and timely resolution of payment discrepancies. The role requires expertise in the insurance billing process, a deep understanding of industry regulations, and a commitment to maintaining accurate customer files.

Key Responsibilities:

Insurance Claims Follow-Up: Manage and track the follow-up process for health insurance claims with insurance companies and patients, ensuring timely resolution of any outstanding payments.

Claims Denial and Appeals Management: Handle the process of claim denials and appeals, ensuring that all necessary documentation is provided and claims are resubmitted in compliance with insurance regulations.

Regulatory Awareness: Stay informed of changes in insurance carrier rules, regulations, and government and commercial insurance updates to ensure compliance with billing procedures.

Payment Discrepancy Resolution: Research and resolve payment discrepancies, identifying issues and working directly with insurance companies and patients to ensure accurate billing and payments.

Accounts Receivable Management: Maintain and update customer files, ensuring that all accounts are accurately recorded and filed in the system.

Effective Use of Payer Websites: Utilize payer websites for follow-up, claim re-billing, and status updates to ensure prompt resolution of claims.

Explanation of Benefits (EOB): Review and interpret EOB statements, explaining them clearly to patients and internal teams as necessary.

Billing Errors and Corrections: Identify and correct billing errors, ensuring that all claims are submitted accurately and payments are received without issues.

Claims Re-Submission: Re-submit claims to insurance carriers when necessary, ensuring that all documents and information are complete.

Team Collaboration: Participate in team efforts to improve the AR process, meet departmental goals, and contribute to the overall success of the finance team.

Job Skill

Accounts Receivable Management Effective Use of Payer Websites Claims Re-Submission

Total Positions:

1

Job Type:

Full Time

Shift:

Evening

No Preference

Intermediate / A-Levelor higher

Experienced Professional

Experience:

1 Year - 3 Years

60000 -80000

Medical Insurance, Provident Fund, Market Competitive Salary