AR Analyst for Medical Financial Affairs

AR Analyst for Medical Financial Affairs Job Description Duties: Portfolio Aging Analytics & Trend Isolation: Analyze outstanding amounts by insurance category, provider, and age category; run daily, weekly, and monthly accounts receivable age reports. Systemic Denial Root-Cause Diagnosis: Examine systemic claim rejection waves to determine whether errors are caused by backend clearinghouse rules, clinical documentation omissions, front-end registration issues, or credentialing lapses. High-Value & Complex Claim Resolution: Manage complex appeal chains, contract modifications, and high-value disputes directly; gather clinical notes, medical necessity charts, and payer policy documents to ensure maximum compensation. Payer Behavior & Underpayment Tracking: To find and flag systematic insurance underpayments or inaccurate write-offs, compare Electronic Remittance Advices with contractual fee schedules. Operational Workflow Optimization: To enhance recovery velocity, assign specific, high-probability claim files to frontline AR Callers and translate intricate financial data patterns into meaningful follow-up actions. Focus Skills: Advanced RCM Analytics & Portfolio Diagnostics: Deep expertise in evaluating end-to-end healthcare revenue cycles, estimating collection percentages, and doing root-cause evaluations on medical aging trends. Mastery of Denial Frameworks & Payer Policy: Thorough knowledge of Claim Adjustment Reason Codes (CARCs), Remittance Advice Remark Codes (RARCs), and localized coverage determinations (LCD/NCD) across government and private pay-structures. Multi-Platform Medical Billing Software Navigation: Command of major enterprise health records (EHR) and practice management technologies (such as Epic, eClinicalWorks, Allscripts, AdvancedMD, NextGen, or Kareo). Medical Coding & Modifier Application Knowledge: Practical experience with ICD-10-CM diagnostic logic, evaluation and management (E&M) guidelines, CPT procedure regulations, and standard billing modifiers Apply now to become an integral part of our growing team! With Regards, HR - Maria