Responsibilities: * Manage accounts receivable calls: resolve issues, negotiate payments & denials. * Contribute to revenue cycle management at hospital/physician Billing.
Job Summary: The Pre-Registration / Eligibility Verification Associate is responsible for gathering and verifying patient insurance information prior to service. This role ensures timely and accurate verification of eligibility and benefits to support clean claim submission and minimize denials. Key Responsibilities: * Perform pre-registration of patients by collecting demographics and insurance details. * Verify insurance eligibility and benefits using payer portals, phone calls, or clearinghouses. * Accurately enter and update patient information in the system. * Communicate with patients regarding coverage, co-pays, deductibles, and out-of-pocket estimates. * Identify and escalate coverage issues or discrepancies. * Coordinate with scheduling, registration, and billing departments as needed. * Maintain documentation in compliance with HIPAA and company policies. Requirements: * 02 years of experience in healthcare, insurance verification, or revenue cycle preferred. * Understanding of basic insurance terminology (HMO, PPO, deductible, co-pay, etc.). * Strong attention to detail and data accuracy. * Excellent communication and customer service skills. * Familiarity with EMR systems or patient access software is a plus. * High school diploma or equivalent required; associate degree preferred.
Job Summary: We are seeking a dedicated and detail-oriented Credentialing Specialist with at least 2 years of experience working in a provider office . The ideal candidate will manage the full lifecycle of provider credentialing and payer enrollment processes to ensure timely billing and revenue recognition within the Revenue Cycle Management (RCM) framework. Key Responsibilities: Manage end-to-end provider credentialing and re-credentialing processes with commercial and government payers. Complete payer enrollment applications for Medicare, Medicaid, and private insurers. Maintain and update provider profiles in CAQH , PECOS , NPPES , and other relevant portals. Liaise with providers to obtain, verify, and validate all required documentation (licenses, certificates, malpractice insurance, etc.). Monitor and track credentialing expirations , license renewals, and re-attestation schedules. Work closely with billing and compliance teams to ensure timely payer setup and claims processing. Maintain accurate and up-to-date records in credentialing databases or software. Ensure compliance with HIPAA , NCQA , JCAHO , and payer-specific standards. Resolve enrollment issues and follow up on pending applications with payers and agencies. Communicate credentialing status to providers, management, and RCM teams. Required Skills & Qualifications: Experience: 2 -4 years of hands-on experience in credentialing from a provider office setting . Strong knowledge of: CAQH, PECOS, NPPES Medicare/Medicaid enrollment Commercial payer requirements and portals (e.g., Availity) Familiarity with RCM and its impact on credentialing. Proficiency in MS Office tools (Excel, Word, Outlook). Excellent verbal and written communication skills. Strong attention to detail and ability to manage multiple tasks. Understanding of credentialing compliance guidelines (HIPAA, NCQA, etc.).
Job Summary: We are seeking a motivated and detail-oriented AR Caller with 6 months to 2 years of experience in physician or hospital billing . The ideal candidate will be responsible for performing follow-ups with insurance companies in the US healthcare domain to ensure timely and accurate payment of claims. Key Responsibilities: Review and analyze denied and unpaid claims. Follow up with insurance carriers via phone calls and web portals. Resolve claim issues such as denials, rejections, or incorrect payments. Understand and apply CPT, ICD-10, and HCPCS codes in billing and follow-up. Update billing software with appropriate notes and statuses. Meet daily/weekly productivity targets and quality standards. Work closely with the billing team to ensure claim resolution. Maintain up-to-date knowledge of insurance guidelines, reimbursement policies, and healthcare billing procedures. Required Skills & Qualifications: Experience: 6 months to 2 years of AR calling in physician or hospital billing (US healthcare). Knowledge of: Denial management Insurance follow-up (Commercial & Government payers) EOBs, ERA, and payment posting Revenue Cycle Management (RCM) Strong communication and interpersonal skills. Ability to work in a fast-paced, target-driven environment. Familiarity with medical billing software and MS Office tools. Willingness to work in night shifts .
Job Description: We are looking for a skilled and experienced Senior Medical Coder to accurately assign diagnostic and procedural codes across a wide range of specialties. The ideal candidate will possess strong analytical skills, extensive multispecialty coding knowledge, and the ability to work independently with minimal supervision. As part of our healthcare coding team, you will ensure compliant coding practices to support optimal reimbursement and reduce audit risks. You will also act as a knowledge resource for junior coders and support quality improvement initiatives. Role & responsibilities: Review and analyze clinical documentation for accuracy and completeness. Assign appropriate ICD-10-CM , CPT , and HCPCS Level II codes for diagnoses, procedures, and services across multiple specialties. Ensure compliance with federal, state, and payer-specific regulations . Work collaboratively with providers and clinical staff for documentation improvement and coding clarifications. Perform quality assurance reviews of coded data and support internal and external audits. Provide mentoring/guidance to junior coders when required. Stay updated on changes in coding guidelines, payer rules, and industry standards. Meet daily/weekly productivity and accuracy standards. Preferred candidate profile Certification from AAPC or AHIMA (e.g., CPC , CPC-H , CCS , or CCS-P ) mandatory . 35 years of hands-on coding experience in a multispecialty outpatient/inpatient setting. Proficiency in coding for Optometry, Podiatry, Chiropractic, Dermatology, and General Medicine . In-depth understanding of medical terminology , anatomy & physiology , and healthcare reimbursement . Familiarity with EMR/EHR systems (e.g., Epic, Cerner, eClinicalWorks, or similar). Strong attention to detail and problem-solving skills. Excellent verbal and written communication abilities. Preferred Skills: Experience with denial management and claim resubmission . Prior experience with risk adjustment coding or HCC coding is a plus. Knowledge of HIPAA , CMS , and payer-specific guidelines. Ability to handle high-volume coding while maintaining quality standards.
Job Summary: The AR Caller will be responsible for following up with insurance companies and patients regarding outstanding claims, resolving billing issues, and ensuring timely collection of payments. The ideal candidate will have prior experience in US healthcare revenue cycle management (RCM), particularly in accounts receivable follow-up. Key Responsibilities: Make outbound calls to insurance companies to follow up on pending or denied claims. Review and analyze aging reports to prioritize accounts for collection. Identify issues causing claim rejections or denials and take corrective actions. Update claim status, payment details, and notes accurately in the billing system. Coordinate with the billing team to resolve coding or documentation discrepancies. Escalate unresolved accounts to the appropriate team for further action. Achieve daily, weekly, and monthly productivity and quality targets. Maintain compliance with HIPAA and company policies. Preferred Skills: Experience in physician or hospital billing. Knowledge of denial management and claim resolution workflows. Ability to handle high call volumes efficiently.
Call insurance companies to check claim status and resolve denials. Review EOBs and update claim status in the system. Work on rejections, underpayments, and appeals. Meet daily productivity and quality targets. Provident fund Food allowance