Role & responsibilities
Role Overview & Shift Details
- Shift Timing: US Shift (e.g., 6:00 PM 3:30 AM or similar), Working Days: 5 Days
- Work Mode: Work From Office
- Claim Status: Follow up with the payer to check on Claim Status, Save claim from getting written off by timely following up.
- Denial Analysis: Review and analyze electronically rejected or denied insurance claims using client portals, clearinghouses, and payer websites without making outbound collection calls.
- Root Cause Identification: Identify why US insurance payers (Medicare, Medicaid, commercial insurers) denied claims by checking CPT and modifier codes.
- Reprocessing & Appeals: Correct claim errors, attach required medical records or documentation, and re-submit claims via non-voice/portal channels for timely reimbursement.
- Account/Aging Resolution: Work on pending accounts receivable (AR) aging reports to recover maximum allowable revenue.
- Compliance: Maintain HIPAA compliance and adhere strictly to client-specific medical billing guidelines and turnaround time (TAT) metrics.
Preferred candidate profile
- Experience: 3 to 4 years of hands-on Revenue Cycle Management (RCM) or medical billing experience with a core focus on denials handling.
- Education: Bachelors degree (Graduation) in any stream is mandatory.
- Skills: Good Communication Skills, Strong analytical aptitude, familiarity with CMS-1500/UB-04 claim forms, basic Excel proficiency, and a typing speed of 2530 WPM.
Pay: ₹50,000.00 - ₹60,000.00 per month
Work Location: In person
