Ar Analyst Medical Billing jobs

The AR Analyst is responsible for the timely follow-up and resolution of insurance claims to ensure accurate and efficient reimbursement for healthcare providers. This role involves analyzing A/R data, performing claim status checks, handling denials, and maintaining compliance with U.S. healthcare billing and regulatory requirements. The A/R Analyst plays a critical role in optimizing cash flow, reducing days in A/R, and supporting overall revenue cycle performance.

Essential Functions: In addition to working as prescribed in our Performance Factors specific responsibilities of this role include:

• Perform pre-call analysis and check claim status via payer calls, IVR, or payer web portals.
• Document all claim activities in client software, ensuring a clear and compliant audit trail.
• Conduct post-call analysis and record after-call actions for claims follow-up.
• Review and interpret Explanation of Benefits (EOBs), authorizations, medical documentation, and physician notes prior to contacting payers.
• Analyze A/R data to identify underpayments, denials, and root causes; document with appropriate denial/adjustment codes.
• Ensure compliance with all reimbursement, billing, and regulatory requirements (including HIPAA).
• Convert denials into payments by filing appeals or correcting claim errors.
• Perform eligibility checks, claim submission, and resubmission as required.
• Monitor fresh claims, denials, suspensions, and appeals to ensure timely resolution.
• Meet or exceed daily/weekly productivity and quality targets.

All activities must be in compliance with Equal Employment Opportunity laws, HIPAA, ERISA , and other applicable regulations.

Key Result Areas (KRAs)

Category

Target

Weightage

Remarks

Production

• 100%

40%

Regular claims and denials

Quality

• 98.5%

40%

Achieve your set target on a monthly basis

Follow SOPs and Checklists

• 95%

10%

Follow SOPs, Site Books, and Checklists

Time on System

9 hrs daily

4%

Meet required 9 hrs time-on-system mandate (only 3 days non-adherence allowed)

Shift Adherence

Login before shift time

3%

Meet required shift start/end mandate (only 2 days non-adherence allowed)

Unapproved Leaves

0

3%

No unapproved leaves allowed

All activities must be in compliance with Equal Employment Opportunity laws, HIPAA, ERISA and other regulations, as appropriate.

Minimum Requirements:

• High School (HSC) or Graduate equivalent.
• 2+ years of experience in U.S. healthcare accounts receivable follow-up and/or denial management.
• Strong written and verbal communication skills.
• Working knowledge of medical terminology, ICD-10, CPT, and HCPCS codes.
• Basic computer proficiency.
• Willingness to work continuous night shifts.

Education / Experience / Certification:

• Prior experience in U.S. healthcare BPO/RCM preferred.
• Experience with acute EHR systems (hospital-based electronic health record platforms).
• Familiarity with clearinghouses such as Waystar, Realmed, Availity, Change Healthcare, and ViaTrack.
• Proficiency in MS Excel, MS Word, and Google Sheets preferred.

Skills & Technical Proficiency:

• Strong analytical and problem-solving skills with attention to detail.
• Assertive and effective in resolving unpaid claims.
• Ability to manage multiple tasks while processing high volumes of claims accurately.
• Strong organizational and time management skills.
• Ability to work independently with minimal supervision.
• Commitment to maintaining confidentiality and compliance with HIPAA.

Working Environment/Physical Demands

Working Environment:

• General office environment: Works generally at a desk in a well-lighted, air-conditioned office, with moderate noise levels.
• Periods of stress may occur.

Physical Demands:

• Activities require a significant amount of sitting at office and work desks and in front of a computer monitor.
• Some walking and standing relative to interaction with other personnel.

Travel Requirements:

 None Occasional Moderate Frequent Very Frequent

(25% or Less) (25% - 40%) (40% - 80%) (80% or m

Other possible Unofficial Titles

Unofficial titles may be given by the manager and used for email signature.