How a US Medical Billing Company Scaled AR Follow-Up with Dedicated Specialists
A growing billing company was winning new practices faster than it could hire experienced AR staff.
Illustrative engagement scenario — names and details are representative of typical client situations.
- Client
- Regional medical billing company
- Industry
- Healthcare RCM
- Location
- United States
- Roles hired
- 4 medical billing specialists (AR and denials), 1 certified coder
- Engagement
- Full-time, ongoing
The challenge
Aged receivables over 90 days were growing as new client practices onboarded. Local AR specialists were hard to hire and retain.
The solution
Dedicated billing specialists were trained on the company's PM systems, payer rules and denial workflows, working inside the client's systems with HIPAA-aware safeguards. A certified coder reviewed coding-related denials and fed back to client practices.
The approach
Work was split by payer group, with each specialist owning their queue and reporting daily productivity and outcomes.
Workflow
- Prioritise high-value and near-timely-filing claims.
- Categorise denials by reason code.
- Correct, resubmit or appeal.
- Feed root causes to coding and front-desk teams.
Safeguards
Specialists completed HIPAA training, worked on secured workstations with no local storage and accessed only the systems needed.
Lessons
Denial prevention matters as much as recovery. Weekly root-cause reports helped client practices fix front-end issues.
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