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AR Analyst – Hospital Billing (Day shift)

SolvEdge
Chennai, Tamil Nadu

Apply Now

Job details

Benefits

Health insurance

Qualifications

Patient monitoring
Content management systems
Analysis skills
CPT coding
EMR systems
Care plans

Full job description

AR Analyst – Denial with Hospital Billing (Day shift)

Job Summary

The Denial Management Specialist focuses on analyzing, appealing, and preventing claim denials to optimize reimbursement and reduce recurring revenue loss.

Qualifications

3–5 years hospital denial management experience
Strong knowledge of ICD-10, CPT, DRG validation
Experience with CMS appeals levels (Redetermination, Reconsideration)
Strong analytical and writing skills

Key Responsibilities

Review denial codes (CARC/RARC).
Categorize denials: Clinical, Technical, Administrative.
Identify root causes and trends.
Prepare and submit appeals with supporting documentation:
- Medical records
- Physician notes
- Authorization details
- Coding validation
Draft strong appeal letters citing payer policy and CMS guidelines.
Identify patterns (e.g., recurring medical necessity denials).
Coordinate with Coding, CDI, Case Management, and Patient Access to prevent future denials.
Recommend process improvements.
Handle complex and high-value denied claims.
Track appeal turnaround times and payer response deadlines.
Generate denial trend reports.
Present findings to leadership with corrective action plans.
Ensure appeals meet payer-specific requirements.
Maintain documentation for audit readiness.

How to Apply

Interested candidates can send your portfolio with updated CV and a brief cover letter to [email protected] with the subject line “Denial Management Specialist (Denial Expert)”.

About SolvEdge

Solvedge: Pioneering the Future of Digital Healthcare

Our Expertise

SOLVEDGE stands at the forefront of digital healthcare innovation as a premier healthcare performance company. With over 18 years of dedicated service in the healthcare industry, we specialize in a digital care journey platform that revolutionizes how hospitals and health systems engage, monitor, and connect with patients throughout their healthcare experiences. Our partnership with Fortune 100 medical device companies and hospitals nationwide underscores our position as a trusted partner in healthcare solutions.

Key Features of SOLVEDGE

Our platform is designed to empower healthcare providers with the tools they need to automate and streamline care delivery, thereby improving clinical outcomes and patient satisfaction:

Personalized Care Plans: Leveraging evidence-based data, SOLVEDGE delivers digital care plans customized to meet the individual needs and conditions of each patient.
Real-Time Patient Monitoring: Through daily health checks, assessment, surveys, and integration with wearable devices, our platform facilitates continuous monitoring of patient health.
Automated Care Delivery: We automate essential tasks, including appointment scheduling, sending reminders, and delivering educational content, to enhance patient engagement and reduce administrative tasks.
Remote Patient Monitoring: Healthcare providers can monitor vital signs, symptoms, and treatment plan adherence remotely, enabling timely interventions and proactive care management.

The SOLVEDGE Advantage

Our platform offers significant benefits to healthcare providers and patients alike:

Improved Clinical Outcomes: By facilitating more effective care pathways and enabling early intervention, SOLVEDGE contributes to reduced readmission rates, fewer emergency department visits, and shorter hospital stays.
Enhanced Patient Satisfaction: Patients enjoy a higher quality of care with SOLVEDGE, benefiting from improved communication, comprehensive education, and continuous support.
Cost Savings: Healthcare organizations can achieve substantial cost reductions by minimizing unnecessary readmission, emergency visits, and complications associated with poor care management.

Applications and Impact: SOLVEDGE’s versatility allows for its application across various aspects of healthcare, with a particular emphasis on surgical care. From preparing patients for surgery to monitoring their post-operative recovery, our platform ensures a seamless and supportive care journey. Beyond surgical care, our focus encompasses managing care pathways, enhancing patient engagement through patient-reported outcomes, providing advanced data analytic, integrating with electronic medical records (EMR), and streamlining billing processes. Our comprehensive approach addresses the myriad challenges faced by today’s healthcare industry, backed by our commitment to excellence in service, communication, and customer experience.

A Trusted Partner in Healthcare Innovation: Our strategic relationships and deep understanding of healthcare challenges have positioned us as an indispensable ally to healthcare providers nationwide. As we continue to develop innovative solutions, our goal remains unchanged: to simplify healthcare delivery, improve patient outcomes, and enhance the overall patient experience.

Apply Now

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