Job Description

• Good understanding of insurance procedures and guidelines
• Reviewing claim accuracy prior to claim Scrubbing and Submission
• Analysis and resolution of denied claims/cases. Identify and resolve billing issues
• Benefits / Eligibility, Medical Coding & Basic Demographic Verification
• Quality & AR Analyst, Denial management, AR Specialist and AR Follow Up
• Payment Postings, reimbursement & collection analysis and reporting
• To ensure quality, timeless and accuracy in entire billing process
• Develop and manage to KPIs and dashboards for increasing client satisfaction, outcomes and retention.
• Standardization of processes and workflows for efficient and optimized delivery of service that meets the customer expectations in cost effective manner.
• Develop short and long term business and delivery models that give insights and predictability into key cost contributors.

Requirements

• 3 years or more prior Experience in US Medical Billing
• Minimum Bachelor’s Degree in Commerce/Finance/Arts/ Pharmacy/ Microbiology or related
• Excellent in English communication skills both verbal & written, spoken English in American pronunciation is desired
• Good Command over Excel, word and health industry related software tools
• Excellent Organizational, Analytical skills and able toadapt to changing situations
• Proven Knowledge of basic medical terminologies such as coding-ICD10, CPT & HCPC
• Experienced in Managing the Overall Revenue Cycle
• Knowledge about Data Conversion and EMR implementation
• Knowledge about enrollment & credentialing and EDI & ERA/EFT setup