The AR Follow-up & Denial Management Specialist is responsible for the timely resolution of unpaid, underpaid, and denied medical claims to maximize reimbursement and reduce accounts receivable (AR) aging. This role analyzes denials, identifies root causes, and drives corrective actions including claim resubmissions, appeals, and payer follow-up. The position partners cross-functionally with billing, coding, authorization, and vendor teams to resolve issues impacting reimbursement and overall revenue cycle performance. In addition to transactional responsibilities, this role supports trend analysis, workflow optimization, and performance improvement initiatives. Success in this role requires strong analytical skills, payer knowledge, and the ability to manage high-volume workloads while maintaining accuracy and compliance. Performs other duties as assigned.
Follow up on unpaid, underpaid, and denied claims across commercial, Medicare, and Medicaid payers.
Review EOBs/ERAs to confirm denial or underpayment reasons and take corrective action.
Analyze denial trends, identify root causes, and implement solutions to reduce future issues.
Correct and resubmit claims, file appeals, and ensure compliance with payer requirements.
Communicate with payers and internal teams (coding, billing, prior authorization) to resolve claim issues.
Track claim outcomes, appeals, and payments to meet performance goals and report results.
Collaborate with cross-functional teams and vendors to improve reimbursement processes and workflows.
Stay updated on billing, coding, and payer policy changes to strengthen denial management expertise.
Apply now to join our team.
Apply now to join our team.