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 .