The Medical Billing Specialist is responsible for preparing, submitting, tracking, and following up on medical claims for healthcare providers across the United States. The role ensures accurate reimbursement by complying with federal regulations, payer guidelines, and HIPAA standards while minimizing claim denials and improving revenue collection.

Key ResponsibilitiesInsurance Verification
Verify patient demographics and insurance eligibility.
Confirm coverage, deductibles, copayments, and coinsurance.
Obtain prior authorizations when required.

Charge Entry
Review provider documentation.
Enter patient charges accurately into the Practice Management (PM) system.
Validate diagnosis and procedure codes before claim submission.

Claim Submission
Prepare and submit electronic claims (EDI) to commercial and government payers.
Review claims for completeness and accuracy.
Ensure timely filing according to payer guidelines.

Accounts Receivable (AR) Follow-Up
Monitor unpaid claims.
Contact insurance companies regarding claim status.
Resolve claim rejections and denials.
File corrected claims and appeals.





Payment Posting
Post Electronic Remittance Advice (ERA) and Explanation of Advantages (EOB).
Reconcile insurance and patient payments.
Identify underpayments and overpayments.

Denial Management
Investigate denied claims.
Prepare appeal documentation.
Track appeal outcomes.
Reduce recurring denial trends.

Patient Billing
Generate patient statements.
Explain balances and payment options.
Process patient payments.
Coordinate payment plans when applicable.

Compliance
Maintain HIPAA compliance.
Follow CMS regulations.
Adhere to payer-specific billing policies.
Protect patient confidentiality.

Reporting
Prepare daily productivity reports.
Monitor AR aging.
Analyze reimbursement trends.
Report billing issues to management.
1–3 years of US Medical Billing experience
Experience with physician or hospital billing
Experience in Revenue Cycle Management

Pay: ₹25,000.00 - ₹100,000.00 per month

Work Location: In person

📌 Medical Billing Specialist Kolkata
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