Manager - IP billing & Insurance (RCM)

Role & responsibilities

Verify Patient Insurance Coverage
Confirm inpatient benefits, eligibility, and coverage details with insurance providers prior to or during admission.

Obtain Pre-authorizations & Pre-certifications
Secure necessary approvals from payers for inpatient services to ensure reimbursement.

Generate and Submit Claims
Prepare accurate claims using UB-04 forms, ensuring correct coding (ICD-10, CPT, HCPCS) and charge entry for inpatient services.

Review and Interpret EOBs & Remittance Advice
Analyze Explanation of Benefits (EOBs) and Remittance Advices to identify payment issues, denials, or short pays.

Manage Claim Denials and Appeals
Investigate denied or underpaid claims, correct billing issues, and submit appeals or reconsiderations to insurance carriers.

Coordinate with Clinical and Administrative Teams
Work with physicians, nurses, and case managers to ensure documentation accuracy and timely billing.

Track and Follow Up on Outstanding Claims
Monitor aging reports and follow up with payers to ensure timely payment of inpatient claims.

Resolve Patient Billing Inquiries
Address patient concerns regarding coverage, out-of-pocket costs, and payment options in a clear, professional manner.

Ensure Regulatory Compliance
Adhere to HIPAA, Medicare/Medicaid regulations, and payer-specific billing rules and guidelines.

Maintain Accurate Billing Records and Reports
Document claim activity, maintain billing logs, and generate reports for management or audits.Preferred candidate profile

Qualification : B.COM (Any Graduate)

Experience : Minimum 8 year to a maximum of 10 years in Inpatient (IP) Billing & Insurance (RCM) within the hospital industry

Kindly share your CV to 8660641655 -Ashika

Job Type: Full-time

Pay: ₹65,000.00 - ₹80,000.00 per month

Benefits:

• Health insurance
• Leave encashment
• Provident Fund

Ability to commute/relocate:

• Yelahanka, Bengaluru, Karnataka: Reliably commute or planning to relocate before starting work (Required)

Application Question(s):

• Current CTC

Education:

• Bachelor's (Required)

Experience:

• IP billing & Insurance (Hospital Industry): 8 years (Required)

Language:

• English & Kannada (Required)

Work Location: In person