Key Responsibilities
Code reviews: Translate clinical services into accurate CPT/HCPCS and ICD-10-CM codes for submission.
Claim submission: Prepare clean claims for electronic submission and ensure all required attachments accompany the claim.
Denial management: Track,investigate,and appeal denials; implement process changes to reduce future denials.
Billing accuracy checks: Verify demographics, insurance information, and effective dates to avoid rejections.
patient balance handling: Post payments, issue statements, and set up payment arrangements when needed.
Refund processing: Manage overpayments and refunds as dictated by payer policies and regulations.
Audit readiness: Support internal and external audits with organized documentation and traceable workflows.
Reporting: generate revenue cycle metrics (A/R days, net collection rate, denial reasons) and share insights with leadership.
Compliance monitoring: Ensure billing practices align with HIPAA, payer policies, and state/federal regulations.

📌 Medical Billing Executive Hyderabad
🏢 Credense Medical Billing
📍 Hyderabad