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Accounts Receivable Specialist (Healthcare Revenue Cycle Management)

Ventra Health
Ventra health
1-3 years
preferred by company
Hyderabad
1 May 13, 2026
Job Description
Job Type: Full Time Education: M.Pharm/B.Pharm or M.Sc. Skills: Clinical Trials, Cross-Functional Teams, Drug Development, Lifesciences, Negotiation Skills, People Management, Problem Solving Skills, Regulatory Compliance, Risk Management, Strategy Execution, Clinical Trials, Detail-Oriented, Drug Development, Lifesciences, Negotiation Skills, Regulatory Compliance, Clinical Trials, Functional Teams, Literature Review, Management Skills, Medical Information, Medical Records, Medical Strategy, Pharmacovigilance, Regulatory Compliance, Risk Management, Safety Scien, Coaching Skills, Data Science, Environment, Experiments Design, Health And Safety (Ehs), Laboratory Equipment, Manufacturing Process, Materials Science, Process Simulation, Sop (Standard Operating Pro, Collaboration, Communication Skills, gmp, GMP Guidelines, Operational Excellence, Problem Solving Skills, Quality Agreements, Quality Compliance, Quality Management, Quality Standards, Regulatory Requ, Communication Skills

Job Title: Accounts Receivable Specialist (Healthcare Revenue Cycle Management)

Location: Hyderabad, India
Work Mode: Onsite
Shift: Night Shift
Employment Type: Full-Time
Industry: Healthcare / Revenue Cycle Management / Medical Billing / Insurance Claims / Healthcare BPO

About the Role

We are looking for an experienced Accounts Receivable Specialist to join our healthcare revenue cycle management team. This role focuses on insurance claims follow-up, denial resolution, accounts receivable collections, reimbursement analysis, appeals management, and medical billing operations.

The ideal candidate will work closely with insurance payers, billing teams, and internal stakeholders to resolve unpaid or denied claims, ensure timely reimbursement, and maintain billing compliance with healthcare regulations.

This role is ideal for professionals with experience in US healthcare AR follow-up, medical billing, claims processing, denial management, and insurance collections.


Key Responsibilities

Accounts Receivable Management

  • Manage assigned AR work queues and prioritize outstanding claims for timely follow-up.
  • Analyze collections, unpaid claims, and non-payable accounts.
  • Ensure claims are reimbursed according to payer contracts and billing timelines.
  • Maintain productivity and quality standards for AR operations.

Insurance Claims Follow-up

  • Perform follow-up on:
    • Claim rejections
    • Claim denials
    • Non-adjudicated claims
    • Pending insurance claims
  • Contact insurance companies regarding outstanding claims.
  • Respond to payer claim inquiries through phone or written communication.
  • Conduct inbound and outbound insurance follow-up calls.

Denial Management & Appeals

  • Investigate denied claims and determine root causes such as:
    • Coverage issues
    • Missing authorizations
    • Medical record documentation requests
    • Filing errors
    • Billing discrepancies
  • Draft and submit appeal letters using standard guidelines.
  • Follow up on appeal submissions for timely claim resolution.
  • Target first-contact resolution wherever possible.

Payment Investigation & Claim Resolution

  • Review systems for:
    • Missing payments
    • Underpayments
    • Delayed claim adjudication
    • Billing mismatches
  • Resolve reimbursement discrepancies efficiently.
  • Recommend account write-offs where justified through adjustment requests.

Patient Account Research

  • Research patient billing accounts to identify claim issues.
  • Review correspondence and account notes to determine next actions.
  • Properly document claim follow-up activities and billing updates.

Billing Compliance

  • Apply working knowledge of:
    • Medicare
    • Medicaid
    • Coordination of Benefits (COB)
    • Modifiers
    • Explanation of Benefits (EOB)
    • Insurance billing rules
  • Ensure compliance with applicable healthcare billing regulations.

Reporting & Operational Communication

  • Report filing rule changes, payer address changes, and reimbursement issues to management.
  • Collaborate with internal teams for billing resolution and escalation management.

Additional Responsibilities

  • Support special AR projects and operational improvement initiatives.
  • Maintain adherence to organizational policies and quality standards.