AR & Claims Resolution Specialist -Medical Billing

1 day ago


Wapda Town, Pakistan Macrise Tech Solutions Full time 800,000 - 960,000 per year

Position Overview

We are seeking a highly organized and results-driven Accounts Receivable & Denials Resolution Specialist to join our medical billing team. In this pivotal role, you will manage outstanding claims, resolve insurance denials, and ensure timely reimbursements from payers. The ideal candidate will have strong analytical skills, a proactive problem-solving mindset, and the ability to maintain clear, professional communication with patients, providers, and insurance representatives.

Key ResponsibilitiesAccounts Receivable & Denials Management

  • Monitor and manage outstanding insurance claims to minimize the accounts receivable (AR) balance.
  • Review and resolve claim denials on a daily basis.
  • Analyze Electronic Remittance Advice (ERA) data to identify and address recurring denial trends.
  • Prepare, submit, and track appeals for denied or underpaid claims with accurate documentation.
  • Investigate payment discrepancies and escalate complex cases to the Billing Manager when necessary.
  • Maintain and update AR aging reports, providing weekly and monthly status updates.
  • Process claims for specialized services, including TMS, Spravato, and psychological testing.
  • Partner with the Billing Manager to meet AR resolution and collection goals.

Patient & Provider Support

  • Address billing-related inquiries from patients, providers, and internal teams.
  • Review patient accounts for accuracy, update balances, and initiate collections when applicable.
  • Collaborate with providers to correct claims, including diagnosis codes and supporting documentation.
  • Communicate with insurance companies regarding prior authorizations, coverage details, and network status.
  • Resolve patient concerns with professionalism and process refunds as needed.

System Support & Process Improvement

  • Submit and track system support tickets in eClinicalWorks (eCW) for billing issues.
  • Provide training and guidance to team members on AR and denial resolution procedures.
  • Collaborate with U.S.-based teams to ensure timely, accurate claim submissions.
  • Participate in regular meetings to review AR performance, identify process improvements, and enhance workflow efficiency.
  • Stay up-to-date on payer policies, compliance requirements, and industry best practices.

Job Type: Full-time

Pay: Rs40, Rs80,000.00 per month

Ability to commute/relocate:

  • Wapda Town: Reliably commute or planning to relocate before starting work (Required)

Application Question(s):

  • Willing to work the night shift?

Experience:

  • Medical Billing: 1 year (Preferred)

Language:

  • English (Required)

Work Location: In person



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