AR Follow-Up & Denial Management RCM Agent

Position Summary: 

The AR Follow-up & Denial Management RCM Agent is responsible for timely resolution of unpaid and denied medical claims to maximize reimbursement and reduce AR aging. The role involves payer follow-ups, denial analysis, claim corrections, and appeal submissions while ensuring compliance with U.S. healthcare billing regulations.

Key Responsibilities

• Follow up on unpaid, underpaid, and denied claims with commercial, Medicare, and Medicaid payers
• Analyze denials, identify root causes, correct claims, and submit resubmissions or appeals
• Communicate with payers and internal teams (coding, billing, authorization) to resolve issues
• Maintain accurate documentation and comply with HIPAA and payer guidelines
• Meet productivity, accuracy, and turnaround time targets

Required Experience & Skills

• 3+ months of experience in AR Follow-up and/or Denial Management (U.S. healthcare RCM)
• Strong knowledge of claim life cycle, denial codes (CARC/RARC), and AR aging
• Working knowledge of EOB/ERA interpretation
• Experience with EMR/EHR, PM systems, and payer portals
• Strong analytical, communication, and documentation skills

Key KPIs

• AR days reduction
• Denial overturn rate
• First-pass resolution rate
• Net collection rate
• Productivity and quality scores

Benefits:

Benefits include medical insurance, paid leave and holidays, and a 401K