Patient Caller

Job Description

Job Summary: The Patient Caller Denials & Physician Billing Specialist is responsible for contacting patients regarding outstanding balances, insurance issues, and denied claims. This role also includes working closely with payers to resolve billing denials, processing physician claims, and ensuring timely and accurate reimbursement.line the day-to-day responsibilities for this role. Key Responsibilities: Patient Calling: Contact patients regarding unpaid balances, missing insurance information, or claim denials. Educate patients on their financial responsibilities, insurance coverage, and payment options. Handle patient inquiries related to statements or billing discrepancies. Follow up on payment plans and document all patient interactions in the billing system. Denials Management: Analyze explanation of benefits (EOBs) and denial codes to determine cause. Appeal denied claims and submit necessary documentation to payers. Track and report denial trends to identify recurring issues. Communicate with insurance companies to resolve authorization or coding issues. Physician Billing: Prepare and submit professional (physician) claims (CMS-1500) to insurance carriers. Ensure correct CPT/ICD-10 coding for services rendered. Verify patient eligibility and benefits prior to billing when needed. Monitor aging reports and work rejections or underpaid claims. Required Skills & Qualifications: Graduate, diploma or equivalent; associate degree 1 to 5 years of experience in medical billing, denials, or collections (physician billing experience preferred). Strong knowledge of insurance processes, denial codes, and medical terminology.. Strong communication and problem-solving skills. Familiarity with HIPAA and healthcare compliance standards. Work Environment: 5 days working (Monday to Friday). Two-way cab facility provided. Candidates must be comfortable working in PST shift timings (Pacific Standard Time).