Accounts Receivable
As a TRAR, candidates with a graduates are enrolled in a salary-paid on-the-job training program and are given the opportunity to learn all US healthcare Medical billing processes, gains technical knowledge of claim life cycle management, payer adjudication logic, denial codes (CARC/RARC), EOB/ERA interpretation, and system workflows while supporting status checks, documentation updates, and basic denial identification within defined productivity standards.
Performs detailed claim follow-ups using payer portals and call interactions, analyzes remittance data, identifies underpayments and denial reasons, initiates corrected claims or appeals, and updates practice management systems to support AR days reduction and cash acceleration.
Manages complex denial categories such as medical necessity, authorization, bundling (CCI edits), timely filing, and coding-related denials by conducting root cause analysis, preparing structured appeals with clinical documentation, and minimizing revenue leakage across high-value accounts.
Executes transaction-level audits on follow-up actions and appeals, validates denial categorization accuracy, measures adherence to SOPs and payer guidelines, performs trend analysis on recurring denial codes, and implements CAPA frameworks to improve first-pass resolution rates.
Monitors daily operational dashboards including AR aging buckets (0–30, 31–60, 61–90, 90+), denial ratios, productivity metrics, and collection effectiveness; ensures queue prioritization based on dollar value and aging risk while managing escalations and compliance adherence.
Conducts payer-wise performance analysis, evaluates underpayment patterns against contract terms, drives workflow optimization initiatives, supports automation integration (RPA/ERA auto-posting), and ensures consistent KPI alignment across multiple operational units.
Leads revenue performance reviews through variance analysis, identifies systemic process gaps across front-end and mid-cycle impacting AR, oversees forecasting and capacity planning, and strengthens controls around high-dollar aging and denial prevention strategies.
Owns end-to-end AR governance by defining denial management strategy, contract compliance monitoring, client escalation frameworks, automation roadmaps, audit controls, and financial performance tracking to ensure optimized net collections and sustainable revenue cycle efficiency.
Charge Entry
As a TRCE, candidates with a graduates are enrolled in a salary-paid on-the-job training program and are given the opportunity to learn all US healthcare Medical billing processes Develops foundational knowledge of charge capture workflows, CPT/ICD coding basics, documentation requirements, and system navigation while assisting with entering routine charges under supervision and learning to identify common posting errors.
Independently enters charges accurately into the system, ensures proper CPT/ICD coding, verifies documentation compliance, and supports timely claim submission to minimize denials and optimize revenue capture.
Handles complex or high-value charge entries, reviews physician documentation for coding accuracy, resolves coding discrepancies, ensures compliance with payer requirements, and mentors junior staff on best practices for accurate charge capture.
Conducts audits of entered charges for accuracy, coding compliance, and adherence to SOPs, analyzes trends in charge entry errors, identifies root causes, and implements corrective and preventive actions (CAPA) to improve first-pass claim accuracy.
Oversees daily charge entry operations, assigns workloads, monitors productivity and quality KPIs, ensures adherence to documentation and coding standards, and manages escalations or complex cases to maintain billing accuracy and TAT.
: Provides operational oversight across multiple teams or accounts, drives process improvements and workflow standardization, monitors high-risk or high-dollar charge entries, and collaborates with coding, billing, and compliance teams to optimize revenue capture and reduce errors.
Leads performance analysis, capacity planning, and workflow optimization initiatives, identifies systemic charge entry issues, develops dashboards and client reporting on charge accuracy, and supports system enhancements to streamline charge capture processes.
Owns end-to-end charge entry strategy, ensuring accurate and compliant charge capture, monitors team and system performance, drives automation and process transformation initiatives, implements quality control frameworks, and partners with revenue cycle leadership to maximize clean claims submission and overall revenue realization.
Payment Posting
As a TRPP, candidates with a graduates are enrolled in a salary-paid on-the-job training program and are given the opportunity to learn all US healthcare Medical billing processes Develops foundational knowledge of remittance processing, including ERAs/EOBs, payer formats, and system workflows, while supporting basic payment posting and reconciliation tasks under supervision, and learning to identify and resolve simple posting discrepancies.
Independently posts standard payments, adjustments, and write-offs in the PM/EMR system, analyzes remittances for accuracy, resolves minor underpayments or unapplied cash, and ensures timely and accurate posting in line with SOPs and TAT expectations.
Handles complex payments, multi-line claims, bulk ERA files, and manual remittances, investigates unapplied or misapplied cash, coordinates with AR and billing teams for accurate allocation, and mentors’ junior staff on advanced posting rules and exception management.
Conducts audits of posted payments and adjustments to ensure compliance with SOPs and payer guidelines, analyzes trends in posting errors, identifies root causes of discrepancies, and implements corrective and preventive actions to improve accuracy and reduce rework.
Oversees daily posting operations by assigning workloads, monitoring productivity and accuracy KPIs, tracking unapplied cash and posting TAT, handling escalations, and ensuring the team adheres to standard protocols and payer requirements.
Provides operational oversight across multiple teams or accounts, monitors high-value payment exceptions, drives workflow optimization and automation (such as ERA auto-posting and RPA integration), and collaborates with AR, billing, and finance teams for complex reconciliations.
Leads process optimization, capacity planning, and reporting, identifies systemic posting issues and high-dollar exceptions, develops dashboards and client updates on posting accuracy, and supports system enhancements to streamline workflows.
Owns end-to-end payment posting strategy, ensuring financial integrity and compliance, monitors team and system performance, drives automation and process transformation initiatives, and partners with AR, billing, and finance leadership to optimize cash flow, minimize unapplied cash, and improve overall revenue cycle efficiency, and partners with revenue cycle leadership to maximize clean claims submission and overall revenue realization.
