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Accounts Receivable Specialist (Healthcare Rcm)

Ventra Health
Ventra health
1-4 years
preferred by company
Hyderabad
1 May 13, 2026
Job Description
Job Type: Full Time Education: B.Sc/M.Sc/M.Pharma/B.Pharma/Life Sciences Skills: Environment, Experiments Design, Health And Safety (Ehs), Laboratory Equipment, Manufacturing Process, Materials Science, Process Simulation, Sop (Standard Operating Procedure), Technical Writing, Wat, GCP guidelines, gmp knowledge, HSE Knowledge , Logistics and Transportation Management, Master Data, Operational Excellence, Sap Erp, supply chain management, Supply Planning, Warehouse Management, ICD-10 CM Codes, CPT-Codes, HCPCS Codes, ICD-10 CM, CPT, HCPCS Coding

Job Title: Accounts Receivable Specialist (Healthcare RCM)

Location: Hyderabad, India (Onsite)
Job Type: Full-Time
Shift: Night Shift
Industry: Healthcare / Revenue Cycle Management / Medical Billing / Accounts Receivable / Healthcare BPO
Department: Accounts Receivable / Insurance Claims / Medical Billing Operations

About the Role

We are seeking a detail-oriented Accounts Receivable Specialist to support healthcare revenue cycle operations, insurance claims follow-up, denial resolution, medical billing collections, and reimbursement management. This role is ideal for professionals with experience in medical billing, accounts receivable, insurance payer follow-up, denial management, healthcare claims processing, and revenue cycle management (RCM).

The ideal candidate will manage outstanding claims, resolve denied or unpaid accounts, communicate with insurance payers, process appeals, and ensure timely reimbursement according to payer contracts and billing compliance standards.

This opportunity is ideal for healthcare RCM professionals looking to grow in accounts receivable and insurance collections operations.

Key Responsibilities

Accounts Receivable & Claims Follow-up

  • Manage assigned accounts receivable (AR) work queues and outstanding healthcare claims.
  • Perform timely follow-up on unpaid, pending, rejected, or denied claims.
  • Ensure claims are reimbursed according to payer contracts and billing timelines.

Insurance Payer Follow-up

  • Communicate with insurance companies regarding outstanding claim status.
  • Handle inbound and outbound calls for claim follow-up and reimbursement resolution.
  • Respond to payer claim inquiries and billing-related questions.

Denial Management & Appeals

  • Review claim denials, rejections, and non-payable accounts.
  • Identify root causes including:
    • Coverage issues
    • Authorization issues
    • Missing documentation
    • Medical record requests
    • Billing discrepancies
  • Prepare and submit appeals using established denial resolution guidelines.
  • Drive one-contact claim resolution wherever possible.

Claims Resolution & Payment Investigation

  • Investigate non-paid, underpaid, and non-adjudicated claims.
  • Review systems for missing payments and payment posting gaps.
  • Recommend account write-offs where appropriate through adjustment requests.

Patient Account Research & Documentation

  • Research patient billing accounts to identify outstanding issues.
  • Properly document account activity, claim follow-up notes, and resolution actions.
  • Review correspondence to determine claim-specific problems and required actions.

Billing Compliance & Reimbursement Accuracy

  • Ensure compliance with healthcare billing rules and payer reimbursement standards.
  • Apply working knowledge of:
    • Coordination of Benefits (COB)
    • Medicare
    • Medicaid
    • Modifiers
    • Explanation of Benefits (EOBs)

AR Workflow Management

  • Prioritize claim follow-up actions based on aging, urgency, and reimbursement impact.
  • Meet production, turnaround time, and quality expectations set by management.
  • Maintain efficient workflow execution in a fast-paced environment.

Reporting & Communication

  • Report address changes, filing rule updates, and reimbursement-related concerns to management.
  • Collaborate with internal billing teams and stakeholders for issue resolution.

Special Projects & Operational Support

  • Support assigned AR improvement initiatives, reporting needs, and operational projects.
  • Contribute to healthcare collections optimization efforts.

Required Qualifications