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Metro location, generic AR role, and unspecified experience increase applicant density.
Specialized medical insurance claims and RCM processes limit cross-industry transferability.
Healthcare RCM domain expertise and claims-handling skills required despite no explicit years.
Manage and maximize accounts receivable collections for RCMS clients through detailed research, follow-up on medical insurance claims, and appeals preparation.
Drive accounts receivable processes to meet key performance indicators (e.g., working 1,400 accounts per month) and support client services by handling client, patient, and carrier communications.
Monitor and reconcile claims including held/unbilled vouchers, denial trends, patient balances, credits, and refunds; resolve complex payer denials and ensure secondary claims payment.
Work Experience Required: Not explicitly mentioned in the JD.
Strong knowledge of medical insurance claims processing and appeals handling is mandatory.
Must be proficient with client office management/administrator systems, clearinghouse and PM rejections, and SharePoint reference/maintenance.
Must demonstrate ability to handle high-volume accounts receivable workload (target of 1,400 accounts per month) with accurate and compliant work.
Experienced in healthcare revenue cycle management, specifically accounts receivable and payer claim denials resolution.
Detail-oriented with capacity to manage complex claim reconciliations and client communications effectively.
Capable of operating under KPI-driven environments with emphasis on error-free transactions and compliance outcomes.