This is a pivotal role in the healthcare revenue cycle management process. This individual is responsible for ensuring accurate charge entry, maintaining accounts receivable, and communicating with patients, insurance companies, and healthcare providers. This combined role requires a strong understanding of medical billing, coding, and excellent communication skills.
Review medical records, super bills, and encounter forms to accurately enter charges.
Assign appropriate medical codes (CPT, ICD-10, HCPCS) for procedures, diagnoses, and services.
Ensure compliance with coding and billing regulations.
Prepare and submit insurance claims, ensuring completeness and accuracy.
Verify patient and insurance information for each claim.
Monitor the status of claims and follow up on denials or rejections.
Resubmit claims as needed.
Accounts Receivable Management:
Monitor accounts receivable aging reports to identify and address outstanding balances.
Contact patients and insurance companies to collect overdue payments.
Negotiate payment arrangements and settlements when necessary.
Verify insurance coverage and benefits for patients before submitting claims.
Communicate with insurance providers to resolve discrepancies.
Update patient records with accurate insurance information.
Demographics and Eligibility:
Ensure patient demographic information is accurate and up to date in the billing system.
Verify patient eligibility for services and update records accordingly.
Appeals and Denials:
Investigate and resolve claim denials and rejections.
Prepare and submit appeals to insurance companies.
Collaborate with healthcare providers and coders to resolve billing issues.
Adhere to healthcare regulations and billing guidelines (HIPAA, etc.).
Stay updated on changes in insurance policies, coding, and billing procedures.
Generate reports on accounts receivable status, charge entry accuracy, and billing performance.
Provide regular updates to management on collections and outstanding balances.
Desired candidate profile:
Minimum 3 years experience in AR calling and payment posting
Proficiency in medical coding (CPT, ICD-10, HCPCS).
Knowledge of insurance billing and reimbursement processes.
Excellent communication and negotiation skills(fair understanding of English Language, verbal and written).
Should be willing to work in night shift.
Should be willing to work from the office location in Bangalore.
Ability to work both independently and collaboratively.
Familiarity with healthcare compliance regulations.
Immediate joiners only
Location: Bangalore- (Candidates residing in & around Kalyan Nagar/ KR Puram/ Kammanahalli area Preferred)
Perks and benefits
According to company standards
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