Key Responsibilities: Audit AR processes including follow-ups, denials, appeals, and collections Review work for accuracy, compliance, and adherence to payer guidelines Analyze denial trends, aging reports, and identify root causes Monitor insurance calling quality and documentation standards Ensure timely and accurate claim resolution as per SLAs Conduct root cause analysis (RCA) and recommend corrective actions Provide structured feedback, coaching, and mentoring to AR teams Participate in calibration sessions and quality audits Prepare and share quality reports and insights with stakeholders Drive continuous improvement initiatives across AR processes
Qualification: Graduate from any discipline
Required Skills: + years of experience in US Healthcare RCM – AR Quality/Audit Strong understanding of AR lifecycle, denials, and appeals Knowledge of payer guidelines and insurance workflows Good analytical and problem-solving skills Strong communication (verbal & written) skills Experience in US payer calling and portals Proficiency in MS Excel and reporting tools
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