Ahmer Choudhary
RCM Specialist | AR & Denials Specialist | Collection Specialist
Marietta,GA
Summary
RCM & AR Specialist with 11+ years of experience in U.S. healthcare revenue cycle management, medical billing, AR follow-up, claims processing, denial management, and insurance appeals. Experienced in handling complex payer issues across commercial, Medicare, and Medicaid plans, with a strong track record of recovering outstanding balances, reducing AR aging, and improving reimbursement outcomes. Skilled in claim submission and follow-up, denial resolution, payment reconciliation, coding, payer communication, and root-cause analysis. Proven ability to achieve 90%+ recovery through effective appeals and persistent account follow-up while maintaining accuracy, compliance, and efficient revenue cycle operations.
Overview
2
2
Languages
11
11
years of professional experience
Work History
RCM Specialist
Exponere Billing
09.2021 - Current
- Managed daily accounts receivable (AR) tasks including claim follow-ups, denials, rejections, and collections to ensure timely reimbursement.
- Managed end-to-end Revenue Cycle Management (RCM) for hospital and physician billing across Commercial, Medicare, Medicare Advantage, Medicaid, Managed Care, PPO, and HMO payers.
- Conducted thorough AR follow-up for denied, unpaid, and underpaid claims, including inpatient and outpatient billing via phone and payer portals.
- Processed explanations of benefits (EOBs), edited claims, and verified insurance eligibility using tools such as Epic, Athenahealth, NextGen, ECW, and Allscripts.
- Monitored 30/60/90+ day AR aging, prioritizing high-value and high-risk accounts to reduce outstanding balances and improve collections.
- Tracked denial logs in Excel and generated reports for senior management, aiding in identification of revenue improvement opportunities.
- Identified and corrected billing discrepancies and coding errors, ensuring compliance with payer requirements and enhancing billing accuracy.
- Managed appeals, reconsiderations, and claim disputes, achieving a 90%+ recovery rate on eligible denied and underpaid claims.
- Executed secondary billing, COB validations, and account adjustments, contributing to reduction of denials and enhancement of claim accuracy.
- Contributed to revenue cycle optimization, reducing claim rejection rates by identifying recurring issues and improving billing processes.
- Reviewed EOBs, claim status, payer responses, eligibility, authorization, and account history to identify and resolve billing issues.
- Collaborated with coding, eligibility, front-end, and clinical teams to resolve billing issues and reduce recurring claim denials.
- Maintained HIPAA, payer, and billing compliance while consistently meeting productivity, accuracy, and quality standards in a high-volume environment.
- Researched payer-specific policies and reimbursement requirements to support denial resolution and maximize claim recovery
Accounts Receivable Specialist
CureMD
04.2016 - 08.2021
- Conducted detailed accounts receivable (AR) follow-up, reducing aging accounts and enhancing cash collections.
- Prepared and submitted well-documented insurance appeals, resulting in a 90%+ recovery rate on denied/rejected claims.
- Verified insurance eligibility and benefits across commercial, government, and workers' compensation plans, ensuring accurate billing.
- Resolved coding discrepancies involving ICD-10, CPT, HCPCS, and modifiers, minimizing denials and ensuring compliance.
- Utilized EHR systems (Epic, NextGen, eClinicalWorks, Cerner) to process claims and streamline billing operations.
- Researched payer-specific guidelines to resolve complex denials and optimize reimbursement outcomes.
- Maintained organized claims inventory system to prevent delays and support timely reimbursements.
- Ensured compliance with HIPAA regulations and payer requirements to protect patient data and support audit readiness
- Utilized Availity, Waystar, Change Healthcare, and TriZetto for claim status, payer research, follow-up, and resolution.
- Resolved complex denials involving coding, eligibility, authorization, medical necessity, and timely filing requirements.
- Submitted 40+ appeals daily, supporting improved claim overturns and reimbursement recovery.
- Reduced AR aging by prioritizing high-balance, high-risk, and timely-filing accounts for proactive resolution
Education
High School Diploma -
North Oconee High School
Bogart, GA05-2014
Bachelor of Business Administration And Management -
Georgia State University
Atlanta, GA 05.2001 -
Skills
- Revenue Cycle Optimization
- Denial Prevention & Root-Cause Analysis
- RCM Analytics & Reporting
- AR Follow-up & Recovery
- Coordination of Benefits (COB)
- HIPAA Compliance & Audit Readiness
- Clean Claim Rate Improvement
- Workflow Optimization
- Denial Management & Appeals
- Payment Posting & Reconciliation
- Proficient in Waystar, TriZetto, Change Healthcare, Availity Pro
- Expert in RCM Systems & Tools Epic, Athenahealth, eClinicalWorks (ECW), NextGen, Kareo, AdvancedMD, HealthFusion, Allscripts
Timeline
RCM Specialist
Exponere Billing
09.2021 - Current
Accounts Receivable Specialist
CureMD
04.2016 - 08.2021
Bachelor of Business Administration And Management -
Georgia State University
05.2001 -
High School Diploma -
North Oconee High School