438 Medicare Jobs - Page 14

Hiring: AR Caller (Denial Management) Location : Pune CTC : Up to 5.5 LPA Shift : US Shift (Night) | 5 Days Working | 2 Days Rotational Off Notice Period : Immediate to 30 Days About the Role We are looking for experienced AR Calling professionals (Provider Side) to join our growing US Healthcare RCM team. Eligibility: Experience: Minimum 1 year in AR Calling (Provider Side) Qualification: Any Key Skills: Revenue Cycle Management (RCM) Denial Management & Resolution AR Follow-up / Collections Physician / Provider Billing Prior Authorization HIPAA Compliance How to Apply? Contact: Sanjana 9251688426

Requirements: • 3+ Years of experience in Health and Welfare benefit administration. • Experience in delivering results across Medicare, COBRA, Workday, FSA, HSA, DVS, DBP Medicare, should be specialize in resolving complex insurance and payroll issues, managing client escalations and improving operational accuracy. • Should have experience in Annual enrollment, Life Events, Vendors Files, Payroll and Premium, Life Insurance, Medicare Benefits, Claim, Billing, etc., • Must be proficient in using Microsoft Office applications (Microsoft Word, Excel, and PowerPoint). • Ability to work towards deadlines. • Positive attitude and solution-oriented thinking. Requirement Excellent communication ski...

DesignationAssistant Operations ManagerReports to (level of category)Manager - Operations Role ObjectiveFollow up is the most essential part in the RCM cycle. It is usually the last step in the cycle after cashposting. After Denial management (AR Follow up), again the cycle starts till the payment is made by the insurance company.Essential Duties and Responsibilities: Establishes and assures compliance with departmental policies and procedures in conformance with corporate policies and procedures. Manages people and drives retention Analysis data to identify process gaps, prepare reports Performance management First level of escalation Work in all shifts on a rotational basis Need to be cost...

DesignationAssistant Operations ManagerReports to (level of category)Manager - Operations Role ObjectiveFollow up is the most essential part in the RCM cycle. It is usually the last step in the cycle after cashposting. After Denial management (AR Follow up), again the cycle starts till the payment is made by the insurance company.Essential Duties and Responsibilities: Establishes and assures compliance with departmental policies and procedures in conformance with corporate policies and procedures. Manages people and drives retention Analysis data to identify process gaps, prepare reports Performance management First level of escalation Work in all shifts on a rotational basis Need to be cost...

DesignationAssistant Operations ManagerReports to (level of category)Manager - Operations Role ObjectiveFollow up is the most essential part in the RCM cycle. It is usually the last step in the cycle after cashposting. After Denial management (AR Follow up), again the cycle starts till the payment is made by the insurance company.Essential Duties and Responsibilities: Establishes and assures compliance with departmental policies and procedures in conformance with corporate policies and procedures. Manages people and drives retention Analysis data to identify process gaps, prepare reports Performance management First level of escalation Work in all shifts on a rotational basis Need to be cost...

SME Responsibilities: 1. Provide expert knowledge and guidance in medical billing procedures, coding, and compliance standards. 2. Process Improvement: Analyze existing billing processes and systems to identify opportunities for improvement in efficiency and accuracy. 3. Training and Development: Develop training materials and conduct training sessions for staff on medical billing best practices, new regulations, and software updates. 4. Audit and Compliance: Conduct regular audits to ensure billing practices comply with regulatory requirements and internal policies. 5. Quality Assurance: Implement quality assurance measures to maintain high standards of accuracy and completeness in billing ...

Greetings from Synthesis Healthcare!!! We are hiring Hospital Billing (Charge Entry) Executive at Chennai location. Required Skills: Extensive hands-on experience in claims editing and billing within a hospital setting. Comprehensive knowledge of UB-04 (CMS-1450) billing practices and requirements. Thorough understanding of Medicare billing guidelines , with particular emphasis on the 72-hour rule and its impact on billing accuracy. Ability to review and interpret medical records and support documentation for billing purposes. Familiarity with accurate assignment and billing of occurrence codes and value codes. Good communication skills, both written and verbal Preferred Skills: Experience w...

Genpact (NYSE: G) is a global professional services and solutions firm delivering outcomes that shape the future. Our 125,000+ people across 30+ countries are driven by our innate curiosity, entrepreneurial agility, and desire to create lasting value for clients. Powered by our purpose - the relentless pursuit of a world that works better for people - we serve and transform leading enterprises, including the Fortune Global 500, with our deep business and industry knowledge, digital operations services, and expertise in data, technology, and AI. We are inviting applications for the role of Domain Trainee / Management Trainee, HRO Responsibilities . Expert in the entire domain of HRO like Trav...

Interested Candidates may connect with Ms.Zoya Shamsi +91 7251000195 (11am-5pm) About the Role: We are seeking a highly motivated and experienced individual with a medical background to join our dynamic team as a Medical Claims Call Center Representative. In this role, you will be the frontline of our customer service, handling inbound calls related to medical claims and rejections. Your primary focus will be to provide exceptional customer service while resolving inquiries and concerns effectively, ensuring a positive experience for every Niva Bupa member. Key Responsibilities: Answer incoming customer calls promptly and professionally. Assist customers with navigating medical claims, inclu...

Role & responsibilities Accurately post all payments (electronic, checks, credit cards, etc.) to patient accounts in the billing system. Ensure all payments are applied to the correct accounts and invoices. Identify and resolve discrepancies between posted payments and actual deposits. Post adjustments, write-offs, and denials as per payer contracts and company policies. Identify trends in denials and underpayments and communicate findings to management. Identify billing errors and make necessary corrections to avoid claim denials. Ensure timely and accurate submission of claims to payers. Manage the resolution of denied claims by identifying root causes and correcting errors. Resubmit corre...

Responsibilities may include the following and other duties may be assigned: As a Team Lead Billing for Patient Financial Services, the role involves the specialist to work closely with various departments to ensure accurate coding, compliance with payer requirements, and maximization of reimbursement on Patient Financial Service accounts receivable metrics. Review and analyze charge capture data for accuracy and completeness. Identify and correct charge errors and discrepancies. Collaborate with clinical and coding staff to resolve charge-related issues. Monitor and review billing processes to ensure compliance with payer guidelines. Identify billing errors and make necessary corrections to...

We are looking for candidates with experience in AR Calling, Eligibility and Verification, and initiating Authorizations in the US Healthcare industry. Perks and benefits Cab facility, PF, Health insurance

Dear Candidate, Greetings from AGS Health.! Job Title: AR CALLER Eligibility: Candidate holding 1-2 years of experience into Medical Billing (Denial Management) can only apply for this position. Working Days - 5 Days (Fixed weekend off) Location: Chennai Interested candidates can WhatsApp their updated resume to 9384898239 Sai Subhiksha HR-Talent Acquisition AGS Health

Hiring: AR Caller/Senior AR Caller Experience in Physician Billing or Hospital Billing Location: Chennai, Bangalore, Pune & Trichy Experience: 1 to 4 Years Salary:Up to 40,000 per month Relieving letter is not mandatory Contact: Suvetha D-9043426511 Required Candidate profile Strong understanding of denial management Work with multiple denial types and take appropriate actions for claim Handle appeals and denial management processes.

Firstsource HIRING for Claims Adjudication !! HR SPOC: Aiswarya HR / 8072289336 Job Title: CSA & Senior CSA Grade: H1/H2 Job Category: Associate Function/Department : Operations Reporting to: Team Lead Roles & Responsibilities (Indicative not exhaustive) A claims examiner needs to analyse multiple documents / contracts and decide to pay / deny the claim submitted by member or providers with respect to client specifications. The claims examiner should also route the claim to different department or provider / member for any missing information that required for claims adjudication. The claims needs to be completed adhering to required TAT and quality SLA. Key Results : Production, Quality Shi...

HEALTHCARE AR PROCESS Thane Location Blended process DOJ - 3rd week of May 24*7 rotational shifts 2 rotational week offs Hsc/Graduate with minimum 6 months experience as AR - Medical billing (mandatory) Required Candidate profile Salary - 25k in hand (based on qualification and/or experience) HR-amcat-ops Follow updated Thane IBU transport boundaries

Primary Responsibilities: The coder will evaluate medical records to verify the plan of care for chronic medical conditions The coder will perform accurate and timely coding review and validation of Hierarchical Condition Categories (HCCs) and Diagnoses through medical records. The coder will document ICD-10-CM codes to verify that coding meets both established coding standards as well as CMS Risk Adjustment Guidelines The coder will assist the project teams by completing review of all charts in line with Medicare & Medicaid Risk Adjustment criteria Apply understanding of anatomy and physiology to interpret clinical documentation and identify applicable medical codes Verify and ensure the ac...

We are looking for a highly skilled and tech-savvy customer support specialist who can provide exceptional support to our U.S.-based healthcare clients. The ideal candidate must have strong knowledge of electronic medical records (EMRs), U.S. healthcare policies, and regulations, along with outstanding problem-solving skills in IT and technology-related issues. A clear American English accent is required to ensure seamless communication with customers. Key Responsibilities: Provide level 1 and level 2 technical and customer support for healthcare clients using our AI and blockchain solutions. Troubleshoot and resolve issues related to EMR/EHR systems, medical billing software, and other heal...

We are looking for a highly skilled and tech-savvy customer support specialist who can provide exceptional support to our U.S.-based healthcare clients. The ideal candidate must have strong knowledge of electronic medical records (EMRs), U.S. healthcare policies, and regulations, along with outstanding problem-solving skills in IT and technology-related issues. A clear American English accent is required to ensure seamless communication with customers. Key Responsibilities: Provide level 1 and level 2 technical and customer support for healthcare clients using our AI and blockchain solutions. Troubleshoot and resolve issues related to EMR/EHR systems, medical billing software, and other heal...

Role & responsibilities Hiring for US Healthcare Enrollment- SPE / SME Company : Cognizant Location - Chennai / Coimbatore Timings: Night shift-US Night shift - (5:30pm - 3:30am) Notice Period: Immediate to 15 days WFH US Night shift SPE : 2 - 4 year in Healthcare & Enrollment CTC - Up to 5 lpa (SPE) upto 6.4 Lpa (SME) Years of exp: 2yrs to 4yrs (SPE) 2yrs to 7yrs (SME) Skills : Healthcare Enrollment with Excellent Communication Interested candidates contact HR Jawahar@8828153744 | jawahar@careerguideline.com

Hiring for Enrollment ( Us Healthcare ) Process : Non voice Location - Coimbatore / Chennai Timings - US Night shift ( 5:30pm to 3:30 am ) Mode - Work From Home Notice Period - Immediate to 15 Days SPE - Upto 5 Lpa SME - Upto 6.4 Lpa SPE 2+yr exp in Enrollment ( Us Healthcare ) SME 4+yr exp in Enrollment ( Us Healthcare ) Interested Candidates contact HR Dinesh@ 9353611283 dinesh@careerguideline.com

Provider Credentialing (US healthcare medical billing) 1. Collect all the data and documents required for filing credentialing applications from the physicians 2. Store the documents centrally on our secure document management systems 3. Understand the top payers to which the practice sends claim and initiate contact with the payers 4. Apply the payer-specific formats after a due audit 5. Timely follow-up with the Payer to track application status 6. Obtain the enrolment number from the Payer and communicate the state of the application to the physician 7. Periodic updates of the document library for credentialing purposes. Required Candidate profile Desired Candidate Profile: 1. Should have...

Job Summary We are seeking a dedicated Product Specialist with 3 to 6 years of experience to join our team. The ideal candidate will have expertise in .NET and ANSI SQL along with a strong background in Medicare and Medicaid Claims. This hybrid role offers the flexibility of working both remotely and on-site with no travel required. The position is a day shift role perfect for those who thrive in a dynamic and collaborative environment. Responsibilities Develop and maintain software applications using .NET technologies to ensure high performance and responsiveness. Utilize ANSI SQL to manage and manipulate databases effectively ensuring data integrity and security. Analyze Medicare and Medic...

Dear Aspirants, We are hiring for experienced IP DRG professionals to join our team at our Mohali location . Eligibility Criteria: Any graduate Mandatory certification in CIC / CCS Medical Coding Minimum 1 year of experience in IP DRG (Mandatory) Strong Communication Skills In-depth knowledge if In-Patient process Flexible to work in rotational shifts, including night shifts Looking for long term commitment If you meet the above requirement and are interested in this opportunity, please share your updated resume with us at: avinash.jeniga@cotiviti.com We look forward to hearing from you! Best regards, Cotiviti Talent Acquisition Team

Skill required: Operations Support - Pharmacy Benefits Management (PBM) Designation: Health Operations New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years Language - Ability: English(International) - Intermediate About Accenture Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song all powered by the worlds largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. Visit us at www.accenture.com What wo...