Experience: 1–4 Years
Responsibilities:
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Follow up on outstanding insurance claims.
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Resolve denials, rejections, and underpayments.
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Analyze EOBs/ERAs and process appeals.
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Meet productivity and collection targets.
Requirements:
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Experience in CMS-1500 Physician Billing AR.
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Knowledge of CPT, ICD-10-CM, HCPCS, modifiers, and payer guidelines.
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Good communication skills.
Experience: 4–6 Years
Mandatory: Prior QA experience in US Healthcare RCM (CMS1500)
Responsibilities:
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Audit AR transactions and documentation.
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Monitor quality, provide feedback, and conduct calibrations.
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Prepare quality reports and ensure SOP/HIPAA compliance.
Requirements:
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QA experience is mandatory.
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Strong knowledge of CMS-1500 AR, denial management, and coding concepts (CPT, ICD-10-CM, HCPCS).
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Good analytical and communication skills.
