Responsibilities: Code surgeries accurately using E/M and ICD guidelines. Collaborate with healthcare providers on RCM processes. Manage denials through effective coding practices.
Role & responsibilities : Claims Processing: Managing and processing insurance claims, including verifying patient information, coding procedures accurately, and submitting claims to insurance companies. Follow-up on Unpaid Claims: Monitoring the status of submitted claims, identifying unpaid or denied claims, and following up with insurance companies to resolve issues and ensure timely payments. Appeals and Disputes : Handling claim denials and rejections by preparing and submitting appeals to insurance companies and resolving billing disputes. AR Aging Management : Managing accounts receivable aging reports and actively working to reduce outstanding balances. Preferred candidate profile: Experience: A minimum of 1-5 years of experience in medical billing and insurance claims processing. Previous experience in a senior or leadership role within a medical billing department is highly desirable. Knowledge: Strong understanding of medical billing procedures, healthcare reimbursement, and insurance claim processes. Proficiency in medical coding (ICD-10, CPT, HCPCS) and knowledge of billing software and electronic health records (EHR) systems. Familiarity with healthcare regulations, including HIPAA, and the ability to maintain compliance.