1. Medical Claim Information Gathering : It is the foundational step of the revenue cycle. It involves collecting precise data points & feeding the info in CRM tools to ensure that when a claim is eventually submitted, it contains no "red flags" that would lead to a denial.
2. Insurance Verification and Authorization: Confirming patient insurance coverage and benefits before appointments and obtaining necessary prior authorizations for specific medical procedures to ensure payment eligibility.
3. Medical Coding and Data Entry: Translating healthcare services, procedures, and diagnoses into standardized codes.
4. Claim Scrubbing and Quality Control: Reviewing claims for errors, missing information, or coding inconsistencies before submission
5. Denial Management and Appeals: Investigating the reasons behind denied or rejected claims, gathering additional medical documentation, and filing formal appeals to overturn insurance company decisions.
6. Accounts Receivable (A/R) Follow-up: Monitoring aging reports to identify unpaid claims and contacting insurance companies to expedite delinquent payments.
1. Monitoring aging reports, contacting insurance companies to expedite payments, and performing AR calling on behalf of provider offices to check claim status (paid claims, denial claims, basic and complex denials).

- Claim Status Collection Agents focus on gathering accurate claim status information as per AR scenarios and successfully closing calls with insurance companies.
- Payment Posting and Reconciliation:



Accurately applying payments from insurance Remittance Advices and patient co-pays to the correct accounts and adjusting balances according to contractual agreements.
- Patient Billing and Customer Service: Generating patient statements for out-of-pocket costs and answering patient inquiries regarding their bills, deductibles, and payment plans.
- Compliance and Record Keeping: Maintaining strict patient confidentiality in accordance with HIPAA regulations and ensuring all billing practices meet federal and state healthcare laws.

1. JOB REQUIREMENT-

1. Bachelor’s degree in any field or equivalent experience.
1. Bachelor’s degree preferred; diploma/graduate equivalent acceptable.

- Experience as a Medical Billing and Insurance Claims Specialist or a similar role , Freshers are not eligible.

1. Prefer candidates with 1–2 years of experience in RCM/Medical Billing, specifically in AR calling or AR followup

- Fluent in English (minimum B2, C1 preferred).
- Experience in the BPO industry is mandatory. (Having an Medical Billing /AR background)
- Excellent communication, analytical, and problem-solving skills.
- Proficient with customer support tools/software. ( Related to Medical Billing )
- Willing to work on weekends, Indian public holidays, and rotational shifting schedules including night shifts. Also as per project needs.
- Willing to WFO only.

Skills:

- Strong written communication skills (grammar, tone, clarity).
- Typing speed: Minimum 35-40 WPM.
- Problem-solving and critical-thinking abilities.
- Adaptability to quick-paced environments and shift work.

- Language Requirement:

- English: Fluent or Business Proficient (B2 and up).

Interested candidates can share their resume - [email protected]

📌 Medical Billing (Kolkata)
🏢 Telus International
📍 Kolkata