Role & responsibilities
Claim Status: Follow up with the payer to check on Claim Status, Save claim from getting written off by timely following up.
Denial Analysis: Review and analyze electronically rejected or denied insurance claims using client portals, clearinghouses, and payer websites without making outbound collection calls.
Root Cause Identification: Identify why US insurance payers (Medicare, Medicaid, commercial insurers) denied claims by checking CPT and modifier codes.
Reprocessing & Appeals: Correct claim errors, attach required medical records or documentation, and re-submit claims via non-voice/portal channels for timely reimbursement.
Account/Aging Resolution: Work on pending accounts receivable (AR) aging reports to recover maximum allowable revenue.
Compliance:



Maintain HIPAA compliance and adhere strictly to client-specific medical billing guidelines and turnaround time (TAT) metrics.

Preferred candidate profile
Experience: 3 to 4 years of hands-on Revenue Cycle Management (RCM) or medical billing experience with a core focus on denials handling.
Education: Bachelors degree (Graduation) in any stream is mandatory.
Skills: Positive Communication Skills, Robust analytical aptitude, familiarity with CMS-1500/UB-04 claim forms, basic Excel proficiency, and a typing speed of 25–30 WPM.

📌 Senior Associate Faridabad (India)
🏢 Data Solutions India
📍 India