120 Denials Management Jobs - Page 2

Designation: AR Caller / Senior AR Caller Experience: Minimum 1 years Strong understanding of UB04 claim forms and related processes Required Candidate profile Notice Period: Immediate joiners or candidates with a maximum 15-day notice period are highly preferred. Job Location Bangalore Email: manijob7@gmail.com Call or Whatsapp 9989051577

Sound knowledge in Healthcare concept. Should have 6 months to 3 Yrs of AR calling Experience. Excellent Knowledge on Denial management. Should handle US Healthcare providers/ Physicians/ Hospital's Accounts Receivable. Required Candidate profile Notice Period: Immediate joiners or candidates with a maximum 15-day notice period are highly preferred. Job Location Bangalore / Chennai Email: manijob7@gmail.com Call or Whatsapp 9989051577

Designation: AR Caller / Senior AR Caller Experience: Minimum 1 years Strong understanding of UB04 claim forms and related processes Required Candidate profile Notice Period: Immediate joiners or candidates with a maximum 15-day notice period are highly preferred. Job Location Bangalore Email: manijob7@gmail.com Call or Whatsapp 9989051577

We are pleased to inform you that we are conducting a Walk-in Drive on 23rd August 2025 (Saturday) from 12:00 PM to 4:00 PM at our Bangalore location. • Experience: Minimum 1 to 4 years in AR domain Role: Associate / Senior AR Associates/ Analyst Required Candidate profile Process: Physician Billing or Hospital Billing - Denial Management Voice Priority: High – quality profiles are requested Job Location Bangalore Email: manijob7@gmail.com Call or Whatsapp 9989051577

Experience: 15 Years (Relieving not mandatory) Shift: Night Shift (US Process) Salary: Best in Industry + Incentives Benefits: Cab Provided + Weekend Off Domain: Physician & Hospital Billing Your expertise in AR Calling deserves the right platform join us and grow Step into a career that values your AR skills. Apply now! Be the voice behind successful claim resolutions we are hiring AR Callers! Turn your AR calling experience into endless opportunities

Medical Coding Trainee Job Category: Healthcare Job Type: Full-Time Job Location: Bangalore Experience: 0-1 years Salary: 3-6 LPA CTC Position Summary We are looking for a Medical Coding Trainee with 0-1 years of experience to join our payment integrity team in Bangalore. This is a vital role focused on converting healthcare guidelines into system-readable configurations. You will be responsible for comprehensive testing and collaborating with cross-functional teams to ensure the accuracy and quality of our medical policy content. This role is ideal for a passionate individual with strong analytical skills and a desire to contribute to the healthcare sector. The work mode for this position is Work from office. Key Responsibilities Analyze and interpret healthcare concepts, medical coding, billing, and reimbursement guidelines to ensure accurate system configuration. Formulate edit requirements by conducting in-depth reviews of contracts, policies, and federal/state regulations. Translate editing logic into platform configurations with support from subject matter experts (SMEs). Collaborate with cross-functional teams to assess configuration needs and validate system outputs. Design and optimize prompts for Large Language Models (LLMs) to generate accurate and clinically relevant medical content. Utilize AI tools (e.g., Gemini, ChatGPT, and Claude) to assist in content creation, review, summarization, and validation. Assist in the development and maintenance of payment integrity policies and procedures. Review configurations to ensure completeness and accuracy based on coding and billing guidelines. Required Qualifications Education One of the following degrees is required: Bachelor of Science in Nursing (B.Sc. Nursing) Pharmacist Degree (B.Pharm, M.Pharm, or PharmD) Life Science Degree (Microbiology, Biotechnology, Biochemistry, etc.) Medical Degree (MBBS, BDS, BPT, BAMS, etc.) Other Bachelor's Degrees with relevant experience Experience 0-1 years of experience in Payment Integrity, Medical Coding, or Denials Management within the US healthcare system. Familiarity with medical coding guidelines such as ICD, CPT, and modifiers. Certifications (Preferred) Candidates with certifications like CPC, CPMA, COC, CIC, CPC-P, or CCS from AHIMA or AAPC will be given preference. Additional weightage will be given for AAPC specialty coding certifications. Key Skills Domain Expertise: Knowledge of US Healthcare Medical Coding, Medical Billing, Payment Integrity, and Revenue Cycle Management (RCM). Codeset Knowledge: Familiarity with CPT/HCPCS, ICD, Modifier, DRG, and PCS. Policy Knowledge: Understanding of policies like Medicare/Medicaid reimbursement, payer payment policies, and CMS policies. Technical Proficiency: Proficiency in Microsoft Word and Excel. Communication: Excellent verbal, written, and interpretation skills. Analytical Skills: Strong analytical, critical thinking, and problem-solving abilities. Other: Willingness to learn new tools, strong time management skills, and ability to meet deadlines.

The primary responsibility of this role is to maintain proper documentation of client software for submission to insurance companies and create a detailed audit trail for future reference. Additionally, the role involves recording post-call actions, conducting post-call analysis for claim follow-ups, and addressing customer inquiries, requests, and complaints effectively through phone calls to ensure prompt resolution at the first point of contact. It is essential to provide customers with accurate information regarding products/services, conduct thorough research on available documentation such as authorizations, nursing notes, and medical records on client systems, and interpret received explanation of benefits before initiating the call. Applicants for this position should have 1-4 years of experience in accounts receivable follow-up/denial management for US healthcare customers. Excellent verbal communication skills and call center expertise are required. Knowledge of denials management and accounts receivable fundamentals is preferred. Candidates must be willing to work night shifts consistently, possess basic computer skills, and ideally have prior experience in a medical billing company with knowledge of medical billing software. Familiarity with the medical billing cycle, healthcare terminology, and ICD-10/CPT codes is advantageous. Interested candidates can reach out to Teena Binu, HR at 9003142494. This is a full-time, permanent position that is open to fresher candidates. The benefits include provided meals, health insurance, paid sick time, paid time off, and provident fund. The work schedule includes night shifts and rotational shifts with a performance bonus. Experience of at least 1 year is preferred. The work location is in person. (Note: Job Types, Benefits, Schedule, Experience, and Work Location details have been excluded from the final Job Description),

Qualifacts is a leading provider of behavioral health software and SaaS solutions for clinical productivity, compliance, state reporting, billing, and business intelligence. The company's mission is to be an innovative and trusted technology partner, enabling exceptional outcomes for its customers and those they serve. Qualifacts offers a comprehensive portfolio, including the CareLogic, Credible, and InSync platforms, catering to the entire behavioral health, rehabilitative, and human services market. With a loyal customer base of over 2,500 customers and more than 6 million patients served, Qualifacts has been recognized for having the top-ranked Behavioral Health EHR solutions in the 2022 and 2023 Best in KLAS: Software and Services report. If you are seeking to work in an environment where innovation is purposeful and your ambition contributes to supporting customers and their communities, then consider applying for the following role: This position is for an onsite Director of Revenue Cycle Management (RCM) based in the Vadodara office, working the NIGHT SHIFT from 6:30 pm to 3:30 am IST, 5 days a week. Remote applicants will not be considered. As the Director of RCM Operations, you will be responsible for leading and optimizing end-to-end revenue cycle operations for the company's US-based healthcare clients. This role requires deep expertise in US healthcare RCM processes, including medical billing, coding, insurance claims, accounts receivable (A/R) management, denials management, and compliance. You will drive process efficiency, ensure regulatory adherence, implement automation solutions, and lead a high-performing team to achieve revenue and operational goals. Key Responsibilities: - Develop and implement best practices, policies, and workflows to optimize revenue cycle performance and ensure compliance with US healthcare regulations. - Drive automation and process improvement initiatives leveraging technology, analytics, and AI-driven solutions. - Set performance metrics, monitor KPIs, and ensure achievement of key revenue cycle objectives. - Foster a culture of accountability, continuous learning, and process excellence within the team. - Analyze revenue cycle trends, identify revenue leakage, and implement corrective actions to improve financial outcomes. - Partner with technology teams to implement and optimize RCM tools, EHR systems, and automation solutions. - Stay updated on industry trends, regulatory changes, and emerging technologies in healthcare RCM. Qualifications: - Advanced degree in Business Administration, Healthcare Management, Finance, or a related field. - Minimum 12+ years of experience in US healthcare RCM, with at least 5+ years in a senior leadership role. - Proven experience in managing large RCM teams and driving performance improvements. - Certifications such as CRCR, CPC, or CRCE are preferred. - Experience in healthcare technology firms, BPO/KPO, or RCM service providers catering to US healthcare clients is preferred. **Qualifacts is an equal opportunity employer that celebrates diversity and is dedicated to fostering an inclusive environment for all employees.**,

We are seeking a Client Partner - AR Quality Analyst with expertise in Revenue Cycle Management (RCM) and Accounts Receivable (AR) processes. The ideal candidate will be instrumental in ensuring high-quality work delivery, identifying training opportunities, and recommending corrective actions to enhance operational efficiency. This role requires excellent communication, interpersonal skills, and the ability to thrive in a fast-paced environment. Key Responsibilities Meet daily with Team Leaders/Supervisors and teammates to review previous day's quality results . Highlight potential issues in operations to management. Work closely with new hires, anyone new to a process, or those experiencing difficulties with errors to ensure future quality work delivery . Trend errors to determine training opportunities . May provide small group or one-on-one training/cross-training . Develop recommendations for corrective action based on quality issues. Maintain current knowledge of billing requirements and system practices and recommend new procedures. Must be able to meet established production and quality standards . Maintain and track accuracy rates for all customers. Skills and Qualifications Skills : Expert-level knowledge in Medical Billing, RCM, and AR processes . Proficiency in Microsoft Word and Excel , as well as Internet/Web applications. Excellent interpersonal skills and the ability to collaborate effectively. Excellent written and verbal communication skills in English . Ability to work in a fast-paced environment and meet deadlines. Qualifications : Experience in Medical-Healthcare billing or Healthcare billing. Only medical billing experienced candidates should apply. People with client servicing experience and process transition experience can also apply. Looking for immediate joiners only.

We are seeking a Client Partner - AR Quality Analyst with expertise in Revenue Cycle Management (RCM), Denials, and Accounts Receivable (AR) processes. The ideal candidate will be instrumental in ensuring high-quality work delivery, identifying training opportunities, and recommending corrective actions to enhance operational efficiency. This role requires excellent communication, interpersonal skills, and the ability to thrive in a fast-paced environment. Key Responsibilities Meet daily with Team Leaders/Supervisors and teammates to review previous day's quality results . Highlight potential issues in operations to management. Work closely with new hires, anyone new to a process, or those experiencing difficulties with errors to ensure future quality work delivery . Trend errors to determine training opportunities . May provide small group or one-on-one training/cross-training . Develop recommendations for corrective action based on quality issues. Maintain current knowledge of billing requirements and system practices and recommend new procedures. Must be able to meet established production and quality standards . Maintain and track accuracy rates for all customers. Skills and Qualifications Skills : Expert-level knowledge in Medical Billing, RCM, Denials, and AR processes . Proficiency in Microsoft Word and Excel , as well as Internet/Web applications. Excellent interpersonal skills and the ability to collaborate effectively. Excellent written and verbal communication skills in English . Ability to work in a fast-paced environment and meet deadlines. Qualifications : Experience in AR QC . People with client servicing experience and process transition experience can also apply. Looking for immediate joiners only.

Qualifacts is a leading provider of behavioral health software and SaaS solutions for clinical productivity, compliance, state reporting, billing, and business intelligence. With a comprehensive portfolio, including the CareLogic, Credible, and InSync platforms, Qualifacts serves the entire behavioral health, rehabilitative, and human services market. They have a loyal customer base of more than 2,500 customers and were recognized in the 2022 and 2023 Best in KLAS: Software and Services report for having the top ranked Behavioral Health EHR solutions. If you are looking to work in an environment where innovation is purposeful and your ambition supports customers and those they serve, this opportunity might be for you! This position is onsite, requiring 5 days/week in the Vadodara office working the NIGHT SHIFT from 6:30pm-3:30am IST. Remote applicants will not be considered. The Director of Revenue Cycle Management (RCM) will oversee end-to-end revenue cycle operations for Qualifacts" US-based healthcare clients. This role involves expertise in US healthcare RCM processes, including medical billing, coding, insurance claims, accounts receivable (A/R) management, denials management, and compliance. The Director will drive process efficiency, regulatory adherence, implement automation solutions, and lead a high-performing team to achieve revenue and operational goals. Responsibilities include developing and implementing best practices, policies, and workflows to optimize revenue cycle performance, ensuring compliance with US healthcare regulations, driving automation and process improvement initiatives, setting performance metrics, monitoring KPIs, and achieving key revenue cycle objectives. Qualifications for this role include an advanced degree in Business Administration, Healthcare Management, Finance, or related field, a minimum of 12+ years of experience in US healthcare RCM with at least 5+ years in a senior leadership role, proven experience in managing large RCM teams, experience with EHR/RCM systems, and automation tools in RCM processes. The ideal candidate will possess strong problem-solving skills, the ability to analyze revenue cycle data, identify trends, and implement process enhancements, excellent communication and stakeholder management skills, relevant certifications such as CRCR, CPC, or CRCE, and experience in healthcare technology firms, BPO/KPO, or RCM service providers catering to US healthcare clients. Qualifacts is an equal opportunity employer that values diversity and is committed to creating an inclusive environment for all employees.,

Preferred Skills, Education, and Experience: Any graduate Good communication skills and fair command of English language Experienced in AR Follow-up and Denials Management Good understanding of the US Healthcare revenue cycle and its intricacies Excellent analytical and comprehension skills Roles and Responsibilities: Review providers claims that have not been paid by the insurance companies Follow-up with Insurance companies to understand the status of the claim - Initiate telephone calls or verify through payer websites or otherwise request the required information from insurance companies. Contact insurance companies for further explanation of denials and underpayments and where needed, prepare appeal packets for submission to payers Based on the responses/ findings, make the necessary corrections to the claim and re-submit/ refile as the case may be Document actions are taken into claims billing system Meet the established performance standards daily Improve skills on CPT codes and DX Codes. Make collections with a convincing approach.

Preferred Skills, Education, and Experience: Any graduate Good communication skills and fair command of English language Experienced in AR Follow-up and Denials Management Good understanding of the US Healthcare revenue cycle and its intricacies Excellent analytical and comprehension skills Roles and Responsibilities: Review providers claims that have not been paid by the insurance companies Follow-up with Insurance companies to understand the status of the claim - Initiate telephone calls or verify through payer websites or otherwise request the required information from insurance companies. Contact insurance companies for further explanation of denials and underpayments and where needed, prepare appeal packets for submission to payers Based on the responses/ findings, make the necessary corrections to the claim and re-submit/ refile as the case may be Document actions are taken into claims billing system Meet the established performance standards daily Improve skills on CPT codes and DX Codes. Make collections with a convincing approach.

Preferred Skills, Education, and Experience: Any graduate Good communication skills and fair command of English language Experienced in AR Follow-up and Denials Management Good understanding of the US Healthcare revenue cycle and its intricacies Excellent analytical and comprehension skills Roles and Responsibilities: Review providers claims that have not been paid by the insurance companies Follow-up with Insurance companies to understand the status of the claim - Initiate telephone calls or verify through payer websites or otherwise request the required information from insurance companies. Contact insurance companies for further explanation of denials and underpayments and where needed, prepare appeal packets for submission to payers Based on the responses/ findings, make the necessary corrections to the claim and re-submit/ refile as the case may be Document actions are taken into claims billing system Meet the established performance standards daily Improve skills on CPT codes and DX Codes. Make collections with a convincing approach.

As a Medical Biller at Furtherance Flora Solutions, you will play a crucial role in processing medical billing, managing insurance claims, handling denials, and appeals. Your expertise in medical terminology and familiarity with Medicare policies will be essential in ensuring accurate and timely billing processes. Your daily responsibilities will involve effective communication with insurance companies and healthcare providers to resolve any billing discrepancies. Your attention to detail, excellent organizational skills, and ability to work in a dynamic healthcare environment will be key to your success in this role. To excel in this position, you should have a minimum of 1-2 years of prior experience in medical billing. Proficiency in medical terminology, experience in managing insurance claims and denials, along with strong communication skills are prerequisites for this role. Join our team of highly experienced professionals at Furtherance Flora Solutions and contribute to providing quality work with 100% efficiency and transparency within agreed turnaround times.,

As a member of the EBO Accounts Receivable team in India, you will be responsible for initiating calls to request the status of claims in the queue. Your main tasks will involve taking appropriate actions on claims to ensure timely resolution, accurate follow-up when necessary, and documenting all actions taken in the claims billing summary notes. Additionally, you will prioritize pending claims for calling from the aging basket and make physical calls following international norms and applicable rules for confidentiality and HIPAA compliance. You will also be tasked with working on denials, rejections, LOA's to accounts, and making necessary corrections to claims. To qualify for this role, you must hold a Graduate Degree. While not mandatory, good communication skills would be a nice-to-have for this position. Guidehouse offers a comprehensive total rewards package that includes competitive compensation and a flexible benefits package, reflecting our commitment to fostering a diverse and supportive workplace. If you are interested in joining Guidehouse and require accommodations during the application process, please reach out to Guidehouse Recruiting at RecruitingAccommodation@guidehouse.com. Rest assured that any information you provide will be kept confidential and used only as needed to facilitate the required reasonable accommodations.,

• Should have excellent communication skills • Take appropriate action on claims to guarantee resolution. • Ensure accurate & timely follow up where required. . Must be willing to Work from Office • Abilities to absorb client business rules. Required Candidate profile Education: Any Graduate Note: Work from office only Working Time: 5.30PM to 2:30AM Working Days: Monday to Friday Transport : Free Cab 2ways Email: manijob7@gmail.com Call / Whatsapp 9989051577

Designation : AR Callers / Senior AR Callers Exp: 1 Y to 5 y Required Skills: Expertise in Physician Billing (CMS-1500) Strong understanding of CMS-1500 claim forms and related processes Strong in Denial Management Good communication skills Required Candidate profile Notice Period: Immediate joiners or candidates with a max 7 day notice period are highly preferred Shift : Day Shift Job Location: Bangalore Email:manijob7@gmail.com Call / Whatsapp 9989051577

The opportunity offers you the chance to work with a client-focused organization rather than one that is technology-focused. You will be eligible for attractive bonus packages in addition to highly competitive compensation. The work environment is described as challenging, vibrant, and growing, providing individuals with the opportunity to develop new skill sets. You should possess 1-5 years of experience in Medical Billing to be considered for this position. Your responsibilities will include having experience in the end-to-end process of medical/healthcare billing in the U.S. It is essential to have good knowledge in denials management, with capturing and action taken experience being mandatory. The working hours are in the general shift from 9am to 6pm, with lunch provided. You will be working 5 days a week with every alternate Saturday off.,

Designation: AR Caller / Senior AR Caller Experience: Minimum 2 years in Hospital billing preferred. Strong understanding of UB04 claim forms and related processes Required Candidate profile Notice Period: Immediate joiners or candidates with a maximum 15-day notice period are highly preferred. Job Location Bangalore / Noida Email: manijob7@gmail.com Call or Whatsapp 9989051577

Designation: AR Caller / Senior AR Caller 1 year to 4 years of experience in AR Calling and should be flexible for night shifts. Experience working with US-based insurance companies and understanding of CPT, ICD-10, and modifiers. Required Candidate profile Notice Period: Immediate joiners or candidates with a maximum 15-day notice period are highly preferred. Job Location Bangalore / Chennai Email: manijob7@gmail.com Call or Whatsapp 9989051577

Designation: AR Caller / Senior AR Caller Experience: Minimum 1 years in Hospital billing preferred. We are urgently looking to hire a Hospital Billing experience candidate Strong understanding of UB04 claim forms and related processes Required Candidate profile Notice Period: Immediate joiners or candidates with a maximum 15-day notice period are highly preferred. Job Location Bangalore / Noida Email: manijob7@gmail.com Call or Whatsapp 9989051577

Designation: AR Caller / Senior AR Caller Experience: Minimum 2 years Strong understanding of UB04 claim forms and related processes Required Candidate profile Notice Period: Immediate joiners or candidates with a maximum 15-day notice period are highly preferred. Job Location Bangalore Email: manijob7@gmail.com Call or Whatsapp 9989051577

Designation: AR Caller / Senior AR Caller Experience: Minimum 2 years in Hospital billing preferred. Strong understanding of UB04 claim forms and related processes Required Candidate profile Notice Period: Immediate joiners or candidates with a maximum 15-day notice period are highly preferred. Job Location Bangalore / Noida Email: manijob7@gmail.com Call or Whatsapp 9989051577

Designation : AR Callers / Senior AR Callers Exp: 1 Y to 5 y Required Skills: Expertise in Physician Billing (CMS-1500) Strong understanding of CMS-1500 claim forms and related processes Strong in Denial Management Good communication skills Required Candidate profile Notice Period: Immediate joiners or candidates with a max 7 day notice period are highly preferred Shift : Day Shift Job Location: Bangalore Email:manijob7@gmail.com Call / Whatsapp 9989051577