8 Hmo Jobs

BeeperMD is a leading healthcare services provider specializing in patient-centric solutions across the U.S. healthcare system. Our mission is to enhance accessibility, efficiency, and quality of care through innovative healthcare support services. With a strong presence in Chandigarh IT Park, BeeperMD offers exciting career opportunities in medical billing, coding, customer service, and inside sales. Our dynamic work environment fosters growth, learning, and collaboration, ensuring employees thrive in the fast-paced healthcare industry. At BeeperMD, we prioritize excellence, compliance, and patient satisfaction while providing a supportive workplace with 5-day working weeks, rotational night shifts, cab facilities, and complimentary meals for our employees. Join us and be part of a team dedicated to transforming healthcare services! For career opportunities, reach out to Pavitark@beepermd.com. Job Description for Medical Biller: 1. Core Technical Skills - Extensive knowledge of Medical Billing (CPT, ICD-10, HCPCS) - Proficiency in Insurance Claim Submission (CMS-1500) - Experience with EHR/EMR Systems, and EDI edits - Knowledge of Medicare, Medicaid, HMO, PPO, Commercial, and Workers" Compensation insurance guidelines - Proficiency in Medical Terminology - Understanding of HIPAA Compliance & Patient Confidentiality - Familiarity with Clearinghouse Portals (Availity, Change Healthcare, etc.) 2. Analytical & Communication Skills - Excellent written & verbal communication - Strong Problem-Solving Skills - Ability to Prioritize Tasks and meet deadlines 3. Experience - Minimum 4-6 years of experience in medical billing and EDI edits management - Specialty-specific billing experience (E&M, OP, Primary & Urgent Care, Telemedicine) - Proven experience in handling claims submission process and EDI edits Bonus Skills - Knowledge of Medical Credentialing Process - Understanding of End-to-End RCM Process - Ability to train & mentor junior billers - Experience with Telemedicine Billing - Multispecialty billing experience,

The Insurance Eligibility and Benefit Verification Specialist is responsible for verifying patient insurance eligibility and benefits prior to medical services being provided. You will ensure that accurate insurance information is obtained and communicated to the medical providers, ensuring smooth billing processes and reducing the likelihood of claim denials or delays. Your role plays a critical role in the revenue cycle management for healthcare providers. As an Insurance Eligibility and Benefit Verification Specialist, your responsibilities and duties will include verifying patient insurance eligibility and benefits through online portals or direct communication with insurance carriers. You will collaborate with healthcare providers to obtain prior authorizations for medical procedures and treatments, resolve discrepancies in insurance information, and address coverage issues promptly. Effective communication with patients regarding their insurance coverage and financial responsibilities is also a key aspect of this role. Preferred skills for this position include a strong understanding of insurance terminology, medical coding (CPT, ICD-10, HCPCS), and insurance plans. Proficiency with medical billing software, Electronic Health Records (EHR) systems, and online insurance portals is highly desirable. Excellent written and verbal communication skills are necessary, with the ability to interact professionally with patients, insurance companies, and healthcare providers. Being detail-oriented, organized, and able to manage multiple tasks in a fast-paced environment is crucial. Knowledge of HIPAA and other healthcare privacy and compliance standards, as well as experience with Medicare, Medicaid, PPO, HMO, and commercial insurance plans, are advantageous. This is a full-time, permanent position with night shift and US shift schedules. The work location is in person. If you meet the qualifications and are interested in this opportunity, please share your resume on the provided contact number +91 6355320395.,

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

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.,

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

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

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

Looking for MBBS Doctor. Role : HMO Location: Siliguri & Guwahati