Cascade Revenue Management - An AIMA Group Company
Website:
cascaderevenue.com
Job details:
Role Summary
The Senior AR Associate will be responsible for managing outstanding insurance claims, resolving denials, following up with insurance payers, identifying root causes of claim delays, and ensuring timely reimbursement for physician practices. The role requires strong analytical skills, payer knowledge, and experience working with physician billing and US healthcare insurance processes.
The ideal candidate should be capable of independently handling AR follow-up, mentoring junior associates, and consistently achieving productivity and quality targets.
Key Responsibilities
Accounts Receivable Management
- Perform timely follow-up on outstanding insurance claims to maximize collections.
- Review unpaid, underpaid, denied, and rejected claims and take appropriate action.
- Work aging reports to reduce outstanding AR and improve collection performance.
- Identify trends affecting reimbursements and escalate recurring issues.
Insurance Follow-Up & Denial Management
- Contact insurance companies via phone and payer portals to determine claim status.
- Resolve denials related to eligibility, authorization, coding, timely filing, medical necessity, and billing edits.
- Submit corrected claims, appeals, reconsiderations, and supporting documentation when required.
- Ensure claims are processed according to payer-specific guidelines.
Revenue Cycle Coordination
- Collaborate with Billing, Payment Posting, Coding, Referrals, Authorizations, and Patient AR teams to resolve claim issues.
- Coordinate with providers and internal stakeholders for missing documentation or clarifications.
- Maintain accurate documentation of all follow-up activities in the practice management system.
Quality & Productivity
- Meet daily productivity, quality, and turnaround time (TAT) targets.
- Ensure compliance with HIPAA and client-specific policies.
- Support process improvement initiatives and share best practices with the team.
- Assist Team Leaders in mentoring and guiding junior AR Associates.
Required Qualifications
Educational Qualification
- Bachelor's Degree in any discipline.
Experience
- Minimum 3–5 years of experience in US Healthcare Accounts Receivable (AR).
- Hands-on experience in Physician Billing / Lab Billing and Insurance Follow-Up.
- Experience working with multiple US insurance payers including Medicare, Medicaid, BCBS, UHC, Aetna, Cigna, Humana, and commercial payers is preferred.
Required Skills & Competencies
- Technical Skills
- Strong understanding of the US Healthcare Revenue Cycle.
- Experience handling denials, appeals, reconsiderations, and claim corrections.
- Knowledge of CPT, ICD-10, HCPCS, modifiers, and EOB/ERA interpretation.
- Familiarity with Practice Management Systems, EMRs, Availity, and payer portals.
Communication Skills
- Excellent verbal and written English communication.
- Strong telephone etiquette while interacting with US insurance representatives.
- Ability to communicate professionally with clients and internal stakeholders.
Analytical & Operational Skills
- Strong problem-solving and root cause analysis skills.
- Ability to prioritize workload and manage multiple payer follow-ups.
- High attention to detail and accuracy in claim documentation.
Leadership Skills
- Ability to mentor junior team members.
- Support quality audits and knowledge-sharing sessions.
- Demonstrate ownership, accountability, and process discipline.
Key Performance Indicators (KPIs)
- Daily productivity and quality targets achieved.
- Reduction in aging AR inventory.
- First-pass denial resolution rate.
- Collections and recovery from outstanding claims.
- Compliance with HIPAA and client SLAs.
- Accuracy of claim documentation and follow-up notes.
Preferred Candidate Profile
We are looking for professionals who:
- Have strong experience in US Physician /Lab AR and denial management.
- Are confident handling insurance follow-up independently.
- Can analyze payer responses and identify revenue leakage.
- Thrive in a fast-paced healthcare operations environment.
- Demonstrate leadership potential and a customer-focused approach.
- Why Join Cascade Revenue Management?
- Work with leading US physician /Lab practices and healthcare clients.
- Exposure to multiple specialties and insurance payers.
- Career growth opportunities within the Revenue Cycle Management division.
- Collaborative and performance-driven work environment.
- Continuous learning and development in US Healthcare RCM.
Click on Apply to know more.
