Medical Billing (Denial management)

Job Description

Job Title: Medical Billing and Insurance Claims Specialist Job Description: Our client, a leading AI platform specializing in medical billing operations, is seeking dedicated and detail-oriented Medical Billing and Insurance Claims Specialists to join our team. The ideal candidates will have at least 1 year of experience in medical billing, insurance claims, or a related field and possess strong English proficiency. As part of our client-facing team, you will be providing vital support to client operations by ensuring accurate and compliant medical billing operations through outbound calling, data categorization, and transcript analysis. Key Responsibilities: 1. Outbound Calling: Make outbound calls to insurance companies and payors to collect essential information, including claim statuses, denial reasons, and any additional relevant details. Conduct all calls in full compliance with the Client's guidelines and applicable healthcare regulations. Maintain professionalism and ensure clear communication during each call. 2. Data Categorization and Labeling: Accurately record, categorize, and label calls or information gathered using the taxonomy and definitions provided by the client. Ensure all claim statuses and call outcomes are properly labeled for consistency in reporting and easy analysis. Deliver categorized data in periodic reports or through the portal developed by client, following the requested format and frequency. 3. Call Transcript Analysis: Analyze recorded call transcripts to extract actionable insights, identifying trends, recurring denial reasons, and other patterns. Compile findings into periodic reports, providing valuable information to the Client to support process improvements and optimize workflows. Qualifications: Minimum of 1 year of experience in medical billing, insurance claims, or a related field. Strong English proficiency, both verbal and written. Familiarity with healthcare regulations and industry guidelines. Excellent communication skills with the ability to make outbound calls to insurance companies and payors. Detail-oriented and able to maintain accurate records. Ability to work independently while adhering to internal guidelines and procedures. Proficiency in Microsoft Office Suite or similar software; experience with medical billing software is a plus.