Revenue Cycle Management (RCM)- Billing Executive – Fresher

About The Company:

We are ITeS-Health Tech KPO providing RCM services to US Healthcare Bureaus, and other services to companies from global locations working in the space of Life sciences and Healthcare We have offices at USA (NY), Mumbai &Gadhinglaj, Dist Kolhapur Maharashtra India

Website - https://www.bhararieservices.com/

Key Roles:

• Claim Submission: Accurately prepare and submit medical claims through designated billing software. Ensure timely submission to prevent reimbursement delays and denials.
• Claim Tracking & Follow-Up: Regularly check the status of submitted claims using appropriate systems. Update internal trackers with the latest claim statuses and follow up on pending or rejected claims.
• Report Generation: Prepare daily, weekly, and monthly reports related to claims, denials, payments, and team productivity. Assist in data analysis to identify trends and support process improvements.
• Patient Financial Responsibility (PFR) Calculation: Calculate patient balances after insurance adjudication, including co-pays, deductibles, and coinsurance. Update patient accounts accordingly and generate billing statements as required.
• Authorization Management: Initiate, track, and follow up on prior authorization requests as per payer and provider guidelines. Maintain proper documentation and communicate authorization statuses to relevant teams.

Key Requirements:

• B.E., B.Tech, B.Sc, M.Sc, BCA, MCA, B.Pharm, D.Pharm, BHMS, BAMS, or any equivalent degree with relevant experience or interest in the Healthcare domain.
• Basic understanding of the healthcare and insurance billing process (training will be provided)
• Proficiency in MS Excel and ability to handle basic reports
• Good verbal and written communication skills
• Strong attention to detail and accuracy
• Ability to meet deadlines in a process-driven environment
• Willingness to learn and adapt quick
• Team player with a positive and proactive attitude