SME - AR Calling Elico Healthcare Services Ltd

3.0 - 7.0 years

0 Lacs

hyderabad, telangana

On-site

The subject matter expert (SME) in this role is responsible for providing in-depth knowledge and expertise in medical billing, insurance follow-ups, and claim resolutions. By leveraging this expertise, you will play a crucial role in ensuring efficient cash flow and reducing outstanding accounts receivable (AR) days. Having prior experience in Emergency Medical Services (EMS) would be an additional advantage for this position. Your essential skills for this role include excellent analytical, problem-solving, and communication skills. You should also have experience in working with aging reports, denials, and appeals processing. Your key responsibilities will revolve around monitoring and managing the AR process, which includes claim submissions, follow-ups, and appeals. You will be tasked with ensuring timely follow-up on unpaid claims, denials, and appeals with insurance companies. Additionally, you will need to analyze aging reports to take necessary actions to reduce outstanding receivables. Categorizing denials to identify trends and root causes, working with clients and insurance providers to resolve recurring denial issues, and serving as a primary point of contact for clients, insurance providers, and internal stakeholders are also important aspects of this role. You will also be responsible for providing regular reports on AR performance, collections, and outstanding receivables. The key measurables for your performance in this role will be AR aging reduction, denial resolution rate, and escalation resolution rate.,

Posted 2 weeks ago

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Medical Billing Specialist - Cardiology Falconre Technohealth Business Solutions Pvt.Ltd

5.0 - 9.0 years

0 Lacs

coimbatore, tamil nadu

On-site

You are an experienced Billing Specialist (Cardiology) with a minimum of 5 years of expertise in cardiology billing. You possess a deep understanding of medical billing, coding, insurance claims, and revenue cycle management specific to cardiology. Your role involves accurately processing cardiology-related claims (CPT, ICD-10, HCPCS codes), verifying insurance eligibility, and ensuring timely submission to insurance providers. You must maintain compliance with HIPAA, Medicare, Medicaid, and private insurance billing regulations while collaborating with physicians, administrative staff, and insurance providers to resolve billing discrepancies. Utilization of EHR/EMR systems (e.g., Epic, Athenahealth, NextGen) for billing and claims processing is essential. Monitoring accounts receivable (A/R) reports and ensuring timely collections and follow-ups are part of your responsibilities. Your qualifications include a minimum of 5 years of medical billing experience in cardiology, strong knowledge of cardiology procedures, diagnostic tests, and insurance guidelines. Proficiency in CPT, ICD-10, and HCPCS coding specific to cardiology, experience with EHR/EMR and medical billing software, and strong analytical and problem-solving skills for claim resolutions and denial management. Excellent communication skills are required for patient and insurance coordination. Possession of Certified Professional Coder (CPC) or Certified Medical Reimbursement Specialist (CMRS) certification is a plus. If you meet the above qualifications and are passionate about cardiology billing and revenue cycle management, we encourage you to apply for this full-time, permanent position with a work schedule including Monday to Friday, night shifts, and rotational shifts at the in-person work location.,

Posted 2 weeks ago

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