Role & responsibilities Perform pre-call analysis and check the status by calling the payer or using IVR or web portal services Maintain adequate documentation on the client software to send the necessary documentation to insurance companies and maintain a clear audit trail for future reference Record after-call actions and perform post-call analysis for the claim follow-up Assess and resolve inquiries, requests, and complaints through calling to ensure that customer inquiry are resolved at the first point of contact Provide accurate product/ service information to the customer, research available documentation including authorization, nursing notes, medical documentation on client's systems, interpret explanation of benefits received, etc prior to making the call Perform analysis of accounts receivable data and understand the reasons for underpayment, days in A/R, top denial reasons, use appropriate codes to be used in documentation of the reasons for denials/underpayments Preferred candidate profile Accounts receivable follow-up/denial management for US healthcare customers Fluent verbal communication abilities/call centre expertise Knowledge of Denials management and A/R fundamentals will be preferred Willingness to work continuously in night shifts Basic working knowledge of computers. Prior experience of working in a medical billing company and use of medical billing software will be considered an advantage. We will provide training on the client's medical billing software as part of the training. Knowledge of Healthcare terminology and ICD/CPT codes will be considered a plus We are hiring fresh graduates as well as experienced resources
Job Summary We are seeking a detail-oriented and experienced Payment Posting Specialist to join our DME billing team. The ideal candidate will be responsible for accurately posting payments, reconciling accounts, and ensuring seamless financial transactions related to insurance and patient payments. This role is critical in maintaining the financial integrity of our clients' DME billing operations. Role & responsibilities Accurately post payments from insurance carriers (e.g., Medicare, Medicaid, commercial payers) and patients to the corresponding patient accounts in the billing system. Reconcile Electronic Remittance Advice (ERA), Explanation of Benefits (EOB), and lockbox deposits with bank statements and billing records. Identify and resolve payment discrepancies, underpayments, overpayments, and zero-pay remits. Process adjustments, write-offs, refunds, and transfers in compliance with payer contracts and DME billing guidelines. Collaborate with the AR team to follow up on denied or partially paid claims and initiate appeals when necessary. Maintain detailed records of all postings and ensure audit-ready documentation. Generate daily/weekly reports on payment posting activities, aging accounts, and cash flow metrics. Stay updated on DME-specific coding (HCPCS), payer policies, and regulatory changes (e.g., HIPAA, CMS guidelines). Assist in month-end closing processes and support internal audits Preferred candidate profile Proficiency in billing software Strong knowledge of EOB/ERA interpretation, CPT/ICD-10/HCPCS codes, and insurance payment methodologies. Excellent mathematical and reconciliation skills with high attention to detail. Proficient in MS Excel (pivot tables, VLOOKUP) and Google Sheets. Ability to handle high-volume transactions with accuracy and efficiency. Strong communication skills for team collaboration and client interactions.
Role & responsibilities Team Management & Delivery Lead a team of 812 DME billing associates; manage rostering, shift discipline, and daily huddles. Allocate work, monitor queues, track SLAs/KPIs, and drive productivity and quality improvements. Conduct coaching, floor support, and monthly performance reviews; manage skill-building and cross-training. Operational Excellence (DME Billing) Oversee eligibility/benefits checks, prior auths, charge entry, claim submission, payment posting (ERA/EOB), AR follow-up, and denials/appeals. Ensure adherence to payer-specific rules for DMEPOS: HCPCS Level II, ICD-10-CM, modifiers (e.g., KX, GA, GZ, RR, NU), capped rentals vs. purchase, same/similar checks, and order documentation requirements. Review edits/rejections, analyze root causes, and implement corrective actions to improve first-pass yield. Quality, Compliance & Documentation Maintain SOPs/work instructions; enforce HIPAA and client data-security protocols. Run audits on samples for accuracy and compliance; publish CAPA where deviations occur. Prepare and share daily/weekly MIS: productivity, quality, DSO, denial trends, aging buckets, and recovery. Stakeholder Communication Serve as first point of contact for internal leadership regarding production/quality status, risks, and escalations. Coordinate with client POCs on clarifications, payer policy updates, and process enhancements. Preferred candidate profile Advanced Excel for reporting (pivot tables, lookups) and data-driven decision-making. Exposure to DME software/EHRs (e.g., Brightree, Kareo, or similar). Strong written and verbal communication, with crisp client-facing updates. Analytical problem-solving, coaching mindset, and change management capability. KPIs You Will Own Clean-claim rate & first-pass resolution rate Denial rate and recovery TAT AR aging (030/3160/61–90/90+) & DSO Productivity per FTE and audit quality score
Job Summary We are seeking a detail-oriented and experienced Payment Posting Specialist to join our DME billing team. The ideal candidate will be responsible for accurately posting payments, reconciling accounts, and ensuring seamless financial transactions related to insurance and patient payments. This role is critical in maintaining the financial integrity of our clients' DME billing operations. Role & responsibilities Accurately post payments from insurance carriers (e.g., Medicare, Medicaid, commercial payers) and patients to the corresponding patient accounts in the billing system. Reconcile Electronic Remittance Advice (ERA), Explanation of Benefits (EOB), and lockbox deposits with bank statements and billing records. Identify and resolve payment discrepancies, underpayments, overpayments, and zero-pay remits. Process adjustments, write-offs, refunds, and transfers in compliance with payer contracts and DME billing guidelines. Collaborate with the AR team to follow up on denied or partially paid claims and initiate appeals when necessary. Maintain detailed records of all postings and ensure audit-ready documentation. Generate daily/weekly reports on payment posting activities, aging accounts, and cash flow metrics. Stay updated on DME-specific coding (HCPCS), payer policies, and regulatory changes (e.g., HIPAA, CMS guidelines). Assist in month-end closing processes and support internal audits Preferred candidate profile Proficiency in billing software Strong knowledge of EOB/ERA interpretation, CPT/ICD-10/HCPCS codes, and insurance payment methodologies. Excellent mathematical and reconciliation skills with high attention to detail. Proficient in MS Excel (pivot tables, VLOOKUP) and Google Sheets. Ability to handle high-volume transactions with accuracy and efficiency. Strong communication skills for team collaboration and client interactions.