Associate Manager - IP billing & Insurance (RCM)

As a skilled Inpatient Billing Specialist in the hospital industry, you will be responsible for verifying patient insurance coverage, confirming inpatient benefits, eligibility, and coverage details with insurance providers prior to or during admission. Your role will involve obtaining pre-authorizations and pre-certifications, generating and submitting accurate claims using UB-04 forms, ensuring correct coding (ICD-10, CPT, HCPCS), and charge entry for inpatient services. You will be expected to review and interpret Explanation of Benefits (EOBs) and Remittance Advice, manage claim denials and appeals by investigating denied or underpaid claims, correcting billing issues, and submitting appeals or reconsiderations to insurance carriers. Collaboration with clinical and administrative teams is crucial, where you will work with physicians, nurses, and case managers to ensure documentation accuracy and timely billing. Tracking and following up on outstanding claims, resolving patient billing inquiries, ensuring regulatory compliance, and maintaining accurate billing records and reports will be part of your routine tasks. Preferred candidates for this role should hold a qualification of B.COM (Any Graduate) with a minimum of 5 years to a maximum of 10 years of experience in Inpatient (IP) Billing & Insurance (RCM) within the hospital industry. This is a full-time position that offers benefits such as health insurance, leave encashment, and Provident Fund. The job may involve working day shifts or rotational shifts, and the ability to commute/relocate to Bengaluru, Karnataka, is preferred. When applying, you will be asked questions about your current CTC, expected CTC, and notice period. A bachelor's degree is required for this role, along with a minimum of 4 years of experience in IP billing & insurance (Hospital Industry). Proficiency in English and Kannada is also required. If you are a detail-oriented professional with experience in inpatient billing and insurance, and possess strong communication and problem-solving skills, we encourage you to apply for this rewarding opportunity.,