Work Timings: 7:30 PM – 4:30 AM IST
Working Days: 5 Days a Week
Job Summary
We are seeking a detail-oriented and compliance-driven Medical Billing & Coding Specialist to manage end-to-end medical billing operations, including accurate coding, claims submission, payment posting, denial management, and accounts receivable follow-ups. The role requires strong knowledge of US healthcare billing regulations, insurance processes, and EHR systems to ensure timely and accurate reimbursement.
Key Responsibilities
Medical Coding & Documentation
Assign accurate CPT, ICD-10, and HCPCS codes to diagnoses, procedures, and services rendered.
Review medical records and clinical documentation to ensure billed services align with documented procedures and diagnoses.
Ensure coding accuracy and compliance with payer-specific and regulatory guidelines.
Insurance Verification & Billing
Verify patient insurance eligibility, perks coverage, and billing requirements before claims submission.
Determine appropriate billing methods based on insurance plans and coverage details.
Generate and submit electronic or paper claims to insurance companies and government payers within defined timelines.
Claims Management & Follow-Up
Monitor submitted claims for status updates, denials, and rejections.
Perform follow-ups with insurance companies to resolve claim issues and ensure timely reimbursement.
Identify root causes of denials and initiate corrective actions.
Payment Posting & Patient Billing
Accurately post payments received from insurance companies, patients, and third-party payers.
Reconcile payments with claims and update patient accounts accordingly.
Generate patient statements for balances not covered by insurance and respond to patient billing inquiries.
Appeals & Accounts Receivable
Prepare and submit appeals for denied or underpaid claims with appropriate supporting documentation.
Review and manage Accounts Receivable (AR) aging reports to identify overdue or unpai