RCM AR Specialist

Allscripts — Pune, India

Work Location - Pune (Work from Office) Shift timings - (7:30 PM - 4:30 AM) IST ​ Essential Duties and Responsibilities Work assigned AR worklists/queues, prioritizing accounts by dollar value, aging bucket, and payer class. Contact insurance payers via phone, online portals, and written correspondence to determine claim status and resolve outstanding balances. Identify and resolve claim denials by analyzing CARC/RARC codes, determining root cause, and initiating appropriate corrective action (resubmission, appeal, or adjustment). Prepare and submit written appeals with supporting clinical documentation for denied or underpaid claims. Verify expected reimbursement against payer contracts and fee schedules, identifying and escalating underpayments. Document all follow-up activity thoroughly in the billing system with clear action notes and next steps. Identify and report denial trends, payer-specific issues, and systemic billing problems to the AR Team Leader. Collaborate with coding, charge entry, patient access, and managed care teams to resolve upstream issues impacting claim payment. Process insurance and patient refund requests as identified during AR review. Meet daily/weekly productivity targets for accounts worked and dollars resolved. Ensure compliance with HIPAA, CMS, timely filing requirements, and organizational policies. Compensation for this job is subject to market conditions, geographic considerations, the candidate’s unique skills and experience, state and local laws, and budget. Our commitment to pay transparency is a testament to our dedication to creating a fair, equitable, and inclusive workplace. By continuously analyzing market trends, staying abreast of changes in state laws, and making budgetary adjustments accordingly, we strive to ensure that our compensation practices reflect the value we place on our associates’ unique contributions and support their professional growth. Enhancing Lives and Building Careers Veradigm believes in empowering

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