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2.0 - 6.0 years
0 Lacs
noida, uttar pradesh
On-site
You will be responsible for working through a book of Accounts Receivable (AR) and developing a plan to maintain proper coverage on all accounts. This includes reviewing aged accounts, tracing, and appealing unpaid or erroneously paid/denied accounts. You will work on all denials and rejections received by researching steps previously taken and taking additional action as necessary to resolve the claim. Additionally, you will review and correct claim rejections received from the clearinghouse, verify eligibility, coverage, and claim status online through insurance portals, and resubmit insurance claims that have received no response or are not on file. Furthermore, you will transfer outstanding balances to patients or the next responsible party when required, make corrections on CMS 1500 claim forms, and rebill claims. Your responsibilities will also involve working on Commercial, Medicaid, Tricare, and Workers Compensation denials/rejections, documenting insurance denials/rejections properly, and communicating claim denials/rejections details related to missing information with the client. You will collaborate with other staff to follow up on accounts until a zero balance is achieved, maintain required billing records, reports, and files, and review and address correspondence daily. It is essential for you to identify trends and inform the client lead/manager as appropriate, escalate issues when necessary, and perform any other responsibilities as assigned. This full-time role is eligible for benefits. To be successful in this position, you must have a minimum of one year of experience working with a healthcare provider or an Associate's Degree in Healthcare Management, Business Management, or a related field. Experience with healthcare billing and collections, various practice management systems, revenue cycle management, and facility and/or professional revenue cycle experience is required. Additionally, proficiency with MS Outlook, Word, and Excel is necessary, along with the ability to work independently and as part of a team. Strong attention to detail, speed while working within tight deadlines, exceptional ability to follow oral and written instructions, flexibility, professionalism, organizational skills, and the ability to work in a fast-paced environment are essential. Outstanding communication skills, both verbal and written, are crucial, as well as being a positive role model for other staff and patients by promoting teamwork and cooperation. Preferred qualifications include experience working in an Ancillary/Ambulatory Surgery Center (ASC), strong Microsoft Office skills in Teams, the ability to quickly identify trends and escalate as appropriate, and the ability to read, analyze, and interpret insurance plans, financial reports, and legal documents. Physical demands for this role include sitting and typing for extended periods, reading from a computer screen for an extended period, and working in a traditional fast-paced and deadline-oriented office environment. You will also work closely with others, engage in frequent verbal communication primarily over the phone and face-to-face, work independently, and frequently use a computer and other office equipment. Key competencies for this position include attention to detail, responsiveness, customer service, execution, and communication. The role is based in Noida, Uttar Pradesh, India, and requires 2 years of experience. The designation for this position is Billing Executive.,
Posted 3 weeks ago
2.0 - 6.0 years
0 Lacs
thrissur, kerala
On-site
As an SME in Denial Management with 2-3 years of experience, you will be a part of Zapare Technologies Pvt. Ltd., a leading provider of Revenue Cycle Management (RCM) solutions for the US Healthcare industry. Your role will involve analyzing, managing, and resolving denied insurance claims to enhance collections and optimize revenue cycles for clients. Your main responsibilities will include developing and maintaining denial logs to identify trends, working with denial reason codes to take appropriate actions, and ensuring compliance with HIPAA, CMS guidelines, and coding standards. You will also manage the appeals process by understanding appeal processes and SOPs, preparing and submitting appeals with accurate documentation, and monitoring deadlines for timely submissions. The ideal candidate will possess a strong understanding of the US healthcare billing cycle, hands-on experience with EMR/EHR systems, in-depth knowledge of billing regulations, coding standards, and compliance frameworks. If you are passionate about healthcare revenue management and proficient in resolving complex denials, we encourage you to apply and be a part of the Zapare team. #Hiring #DenialManagement #RCM #HealthcareJobs #MedicalBilling #RevenueCycleManagement #ZapareTechnologies #CareerOpportunity,
Posted 1 month ago
2.0 - 3.0 years
4 - 5 Lacs
Kochi, Ernakulam, Thrissur
Work from Office
Designation: SME - Denial Management Experience: 2-3 years Skills desired: Detailed knowledge of US healthcare billing cycle Experience working with different EMR/EHR systems like Epic, Cerner, Allscripts, Athenahealth, NextGen, eClinicalWorks, Meditech, etc. Denial analysis and management - Review and analyze denied insurance claims to identify cause of denials such as coding issues, preauthorization, payer-specific policies - Develop and track denial log to monitor patterns and trends in denied claims - Experience talking with payers to obtain clarification with denials and initiate timely appeals when appropriate Expertise in working with denial reason codes (CARC, RARC) and identifying root causes of denials. Strong understanding of billing regulations, CPT, ICD-10, HCPCS codes, and compliance standards (HIPAA, CMS guidelines). Appeals - - Understand 1st, 2nd, 3rd, and External Level Appeal process, system, and documentation SOP - Prepare, submit, and follow up on appeals ensuring all necessary documentation is included - Revie Review assigned denials and EOBs for appeal filing information. Gather any missing information - Review case history, payer history, and state requirements to determine appeal strategy - Obtain patient and/or physician consent and medical records when required by the insurance plan or state - Gather and fill out all special appeal or review forms - Create appeal letters, attach the materials referenced in the letter, and mail them Maintain a record of all appeals and responses to track appeal outcomes and recovery rates Monitor payer response timelines to ensure appeal filing deadlines are met Track insurance company and state requirements and denial trend changes
Posted 1 month ago
8.0 - 12.0 years
8 - 12 Lacs
Bengaluru
Work from Office
Location: Coimbatore Job Type: Full-Time, Onsite (Night Shift) Experience Required: 10+ years Shift Timings: US Shift 6:30 PM to 3:30 AM Notice Period: Immediate to 30 Days About LogixHealth LogixHealth is a physician-founded company delivering cutting-edge revenue cycle management services to healthcare providers nationwide. With a commitment to driving better healthcare outcomes, we combine advanced technology, clinical insight, and unmatched service excellence. Since the 1990s, we have expanded across 40 states, providing innovative coding, billing, and business intelligence solutions that allow providers to focus on patient care while we ensure financial success. Discover more about us at www.logixhealth.com. What We Offer A leadership role in a growing healthcare technology company Inclusive and performance-driven work culture Competitive salary and leadership incentives Continued learning and career advancement opportunities Exposure to advanced RCM platforms and industry best practices Role Overview We are looking for a highly motivated RCM Team Lead with deep expertise in Accounts Receivable (AR) Calling and Denial Management . This role demands a strong leader capable of managing a high-performing team while overseeing complex RCM workflows and driving performance metrics. Key Responsibilities Lead and manage a team of AR callers and denial management specialists Oversee end-to-end accounts receivable processes, including follow-ups, appeals, and denial resolution Analyze and improve team KPIs to ensure process efficiency and target achievement Provide coaching, training, and performance feedback to team members Ensure accuracy and timeliness in billing processes in line with payer requirements Collaborate with internal stakeholders to streamline workflows and escalate issues as needed Utilize RCM software such as Allscripts, ECW, or Medisoft (experience preferred) Prior experience in Emergency Department (ED) specialty billing is a strong advantage Qualifications Minimum 10+ years of experience in Revenue Cycle Management with a focus on AR calling & denials Proven team leadership and management experience In-depth understanding of CMS-1500 claim forms and multispecialty denials Strong analytical and decision-making capabilities Excellent verbal and written communication skills Able to thrive under pressure and meet strict deadlines Willing to work onsite (WFO) and in US Night Shift
Posted 3 months ago
10.0 - 14.0 years
8 - 12 Lacs
Coimbatore
Work from Office
Location: Coimbatore Job Type: Full-Time, Onsite (Night Shift) Experience Required: 10+ years Shift Timings: US Shift 6:30 PM to 3:30 AM Notice Period: Immediate to 30 Days About LogixHealth LogixHealth is a physician-founded company delivering cutting-edge revenue cycle management services to healthcare providers nationwide. With a commitment to driving better healthcare outcomes, we combine advanced technology, clinical insight, and unmatched service excellence. Since the 1990s, we have expanded across 40 states, providing innovative coding, billing, and business intelligence solutions that allow providers to focus on patient care while we ensure financial success. Discover more about us at www.logixhealth.com. What We Offer A leadership role in a growing healthcare technology company Inclusive and performance-driven work culture Competitive salary and leadership incentives Continued learning and career advancement opportunities Exposure to advanced RCM platforms and industry best practices Role Overview We are looking for a highly motivated RCM Team Lead with deep expertise in Accounts Receivable (AR) Calling and Denial Management . This role demands a strong leader capable of managing a high-performing team while overseeing complex RCM workflows and driving performance metrics. Key Responsibilities Lead and manage a team of AR callers and denial management specialists Oversee end-to-end accounts receivable processes, including follow-ups, appeals, and denial resolution Analyze and improve team KPIs to ensure process efficiency and target achievement Provide coaching, training, and performance feedback to team members Ensure accuracy and timeliness in billing processes in line with payer requirements Collaborate with internal stakeholders to streamline workflows and escalate issues as needed Utilize RCM software such as Allscripts, ECW, or Medisoft (experience preferred) Prior experience in Emergency Department (ED) specialty billing is a strong advantage Qualifications Minimum 10+ years of experience in Revenue Cycle Management with a focus on AR calling & denials Proven team leadership and management experience In-depth understanding of CMS-1500 claim forms and multispecialty denials Strong analytical and decision-making capabilities Excellent verbal and written communication skills Able to thrive under pressure and meet strict deadlines Willing to work onsite (WFO) and in US Night Shift
Posted 3 months ago
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