Associate Manager - IP billing & Insurance (RCM)

Role Overview: As an Inpatient Billing Specialist, your primary responsibility will be to verify patient insurance coverage, generate and submit claims, manage claim denials and appeals, and ensure regulatory compliance. You will work closely with clinical and administrative teams to coordinate documentation accuracy and timely billing. Additionally, you will be required to track outstanding claims, resolve patient billing inquiries, and maintain accurate billing records and reports. Key Responsibilities: - Verify patient insurance coverage including benefits, eligibility, and coverage details with insurance providers. - Obtain pre-authorizations and pre-certifications for inpatient services. - Prepare accurate claims using UB-04 forms, ensuring correct coding (ICD-10, CPT, HCPCS) and charge entry. - Review and interpret Explanation of Benefits (EOBs) and Remittance Advice. - Investigate denied or underpaid claims, correct billing issues, and submit appeals or reconsiderations. - Coordinate with clinical and administrative teams to ensure documentation accuracy and timely billing. - Track and follow up on outstanding claims. - Resolve patient billing inquiries. - Ensure regulatory compliance. - Maintain accurate billing records, document claim activity, and generate reports for management or audits. Qualification Required: - Bachelor's degree in Commerce (B.COM) or any other graduate degree. - Minimum 5 years to a maximum of 10 years of experience in Inpatient (IP) Billing & Insurance (RCM) within the hospital industry. Company Details: The company offers benefits such as health insurance, leave encashment, and provident fund. The job type is full-time with opportunities for day shift or rotational shift schedules. Fluency in English and Kannada is required for effective communication. Application Questions: - Current CTC - Expected CTC - Notice Period Please ensure you meet the educational qualifications, experience requirements, and language proficiency mentioned in the job description before applying for the position.,