Identify root causes and partner with billing to prevent repeat issues
Billing Software & Revenue Technology
Work in major EHR/EMR platforms for follow-up, documentation, and posting
Use clearinghouses: Availity, Waystar, ClaimMD for claim status, ERA, and submissions
Navigate payer portals for eligibility, status, and appeal requirements
Build reports and dashboards in Excel using VLOOKUPs and pivot tables
Payer Knowledge & Compliance
Apply deep knowledge of Medicare, Medicaid, and commercial payer guidelines
Ensure appeals meet timely filing and payer-specific requirements
Support prior authorization follow-ups and flag PA-related denial trends
Medical Coding Literacy
Read and interpret ICD-10-CM, CPT, and HCPCS codes Spot coding/modifier errors causing denials — e.g. Modifier 25, NCCI edits Collaborate with coding team on education. Certified coder not required — code literacy is key
Recovery Work & Professionalism
Bring previous dedicated experience in medical AR recovery
Maintain stable work history and professional communication with payers + internal teams
Document everything clearly for audits and handoffs
Shift Time: 5.30 TO 2.30 AM ( +/- 1hrs)
Requirements
Requirements:
3+ years in medical AR recovery/denials. RCM, hospital, or physician practice experience preferred Proven metrics: reduced DSO, recovered $ amounts, increased appeal success rate Hands-on with EHR/EMR + Availity, Waystar, ClaimMD + payer portals Advanced Excel: VLOOKUPs, pivot tables, data analysis for reporting Strong grasp of Medicare, Medicaid, and commercial payer rules Code-literate in ICD-10-CM, CPT, HCPCS. Ability to identify denial-driving errors Detail-oriented, persistent, and excellent at professional written/verbal communication Originally posted on Himalayas
