Medical Coder / Biller QA- Hiring GM Analytics Solutions

4.0 - 8.0 years

6 - 10 Lacs

Gurugram

Work from Office

Job Summary: We are seeking a detail-oriented and experienced Medical Coder / Biller QA professional to join our growing RCM team in GM Analytics Solutions . The ideal candidate should possess a strong background in hospital professional billing and coding, along with an in-depth understanding of insurance workflows and denial management. This role demands accuracy, analytical thinking, and strong compliance awareness in line with healthcare industry standards. Key Responsibilities: Perform accurate coding and billing of hospital professional services, ensuring compliance with CPT, ICD-10, and HCPCS coding standards. Review and resolve coding denials for Inpatient (IP) and Outpatient (OP) claims, with special emphasis on E/M coding . Conduct Quality Assurance (QA) checks on coded and billed claims before submission. Collaborate with cross-functional teams for accurate claims processing and timely resolution of rejections. Prepare and analyze reports using Microsoft Excel for internal audits, performance tracking, and continuous improvement. Maintain up-to-date knowledge of payer policies, HMO , PPO , Medicare , and Medicaid requirements. Ensure strict adherence to HIPAA and other regulatory compliance guidelines. Required Qualifications: Certification: CPC (Certified Professional Coder) Mandatory Experience: Minimum 2+ years of experience in hospital professional billing Minimum 2+ years of medical coding experience , particularly in denials and E/M coding Technical Skills: Proficiency in Microsoft Excel data handling, formulas, reporting Insurance Knowledge: Familiarity with various insurance types such as HMO , PPO , Medicare , and Medicaid Desired Competencies: Strong attention to detail and commitment to coding accuracy Solid understanding of medical terminology, billing rules, and industry updates Excellent communication and documentation skills Ability to manage multiple tasks in a deadline-driven environment Note: This is a Work-from-Office position only. Candidates must be open to working from our physical office location. Apply Now to be a part of our fast-growing, quality-focused healthcare team. Contact - Shivi HR - 7428699980

Posted 2 weeks ago

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Title Claims Specialist MNR Solutions Pvt. Ltd.

1.0 - 5.0 years

0 Lacs

pune, maharashtra

On-site

The Claims Specialist position in Pune requires a candidate with 1+ years of experience and an annual salary of 3.90 LPA. As a Claims Specialist, you will be responsible for accurate entry of patient demographic information, charge entry following the specified procedures, and applying medical billing concepts including knowledge of US Healthcare medical billing rules and insurance guidelines. To excel in this role, you should have a graduate degree with 1-3 years of experience in billing and a good understanding of US Healthcare medical billing rules, abbreviations, and state-specific insurance guidelines. It is essential to maintain high accuracy in charge entry, double-check all entries for completeness and correctness, and conduct thorough charge reviews to ensure revenue generation. Additionally, familiarity with HIPAA regulations and compliance requirements is crucial for this position. The job is full-time with day and morning shifts, and the work location is in person. If you meet these requirements and are looking to utilize your billing experience in a dynamic environment, this Claims Specialist position could be the perfect fit for you.,

Posted 2 weeks ago

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RCM analyst/Senior RCM analyst Interscripts Software

2.0 - 4.0 years

4 - 8 Lacs

Hyderabad

Work from Office

Designation: RCM analyst/Senior RCM analyst Location: Hyderabad Experience: Minimum of 2 years in US healthcare RCM Key Skills: Attention to detail. Prior experience in US healthcare RCM: Strong verbal and written communication skills. * Knowing EPIC (EHR software) will be an added advantage Job description: Claim Investigation & Resolution Analyze denied or delayed HMO claims and identify root causes (e.g., coding errors, authorization issues, eligibility mismatches). Strong understanding of UB04 and CMS 1500 forms Provider Support via Call & Chat Act as a frontline liaison for providers, resolving claim-related issues in real time. Guide payer-specific rules , documentation requirements, and appeals processes. Escalate complex issues to internal teams or payers when necessary. Eligibility & Authorization Verification Confirm patient eligibility and authorization status before claim submission. Educate providers on HMO referral protocols and network restrictions. Denial Management & Appeals Track denial trends, monitor appeal outcomes, and update providers accordingly Prepare and submit appeals with supporting documentation. Compliance & Documentation Ensure all interactions and claim actions comply with HIPAA and payer policies. Maintain detailed logs of provider communications and claim resolutions. Strong understanding of UB04 and CMS 1500 formsRole & responsibilities Preferred candidate profile

Posted 3 weeks ago

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AR Callers ( Denial Management ), prior authorization Axis Services

1.0 - 4.0 years

3 - 5 Lacs

Hyderabad, Mumbai (All Areas)

Work from Office

WE ARE HIRING - AR CALLER - Mumbai, Hyderabad Experience :- Min 1 year into AR caller Mumbai Location :- Package : Max Upto 40k take home Qualification : inter & above Hyderabad Location :- Package : Max Upto 33k take home Qualification : graduation Shift Timings :- 6:30 PM to 3:30 AM WFO Virtual and Walk-in interviews available WE ARE HIRING - Prior Authorization - Mumbai, Chennai Experience :- Min 1 year into Prior Authorization Mumbai Location :- Package : Max Upto 4.6 Lpa Qualification : Graduate Mandate Chennai Location :- Package : Max Upto 40k Qualification : Inter & above Shift Timings :- 6:30 PM to 3:30 AM WFO Virtual and Walk-in interviews available Perks and Benefits 1. 2 way cab 2. Incentives Interested candidates can share your updated resume to HR SAHARIKA - 9951772874(share resume via WhatsApp ) Refer your friend's / Colleagues

Posted 4 weeks ago

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Benefits Configuration Analyst || Mumbai Hird Services

1.0 - 6.0 years

3 - 8 Lacs

Navi Mumbai, Mumbai (All Areas)

Work from Office

Collaborate with US Healthcare Payers to gather and analyze business requirements Configure and validate Products, Agreements, and Benefits in OSCAR, ICIS, and CPBRE system Perform Benefits and Contracts configuration to align with client expectation Required Candidate profile Location: Airoli, Mumbai Experience Required: 1+ Years Shift Timing: Evening / Night Shift Employment Type: Full-time Notice Period: Immediate Joiner Transport Facility: One way Share CV - 9329922452

Posted 1 month ago

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