Medical Billing and Revenue Cycle Management DrCatalyst India

0.0 - 3.0 years

0 - 0 Lacs

ahmedabad, gujarat

On-site

As an Experienced Medical Biller at our healthcare facility, you will play a crucial role in ensuring accurate processing and timely reimbursement of medical claims. Your attention to detail and strong understanding of medical billing processes, insurance claims, and healthcare coding standards will be key in maintaining the financial health of our organization. Your responsibilities will include reviewing and processing medical claims with precision, submitting claims electronically to insurance companies, and resolving any claim denials, rejections, or appeals promptly. You will also be tasked with verifying patient insurance coverage, obtaining necessary authorizations, and communicating effectively with both patients and insurance companies to address billing inquiries and resolve outstanding balances. Collaboration with providers and clinical staff to ensure accurate documentation and coding will be essential, along with generating reports on billing activity, claim status, and outstanding accounts. To succeed in this role, you should possess a diploma or graduation in any field, along with 0-2 years of experience in medical billing. Excellent communication, analytical, and organizational skills are a must, as well as the ability to handle confidential information with discretion and comply with HIPAA regulations. In return for your expertise and dedication, we offer a competitive salary range of 2.58LPA to 4.5LPA, along with a range of benefits including a 5-day work week, health and accidental insurance, paid leaves, referral bonus, leave encashment, monthly performance-based incentives, and complimentary meals, tea/coffee, and snacks. Join our team and make a difference in the healthcare industry while enjoying a supportive work environment and valuable perks.,

Posted 2 weeks ago

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SME - Denial Management Zapare Technologies

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

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