We are looking for a Medical Biller & Eligibility Specialist to support the full revenue cycle for US-based healthcare providers. You will handle patient eligibility and benefits verification, claim submission, payment posting, denial management, and accounts receivable follow-up. This is an onsite role based in Bangalore, India, requiring US business hours, supporting podiatry and orthopedic surgery practices.

KEY RESPONSIBILITIES
- Verify patient insurance eligibility and perks prior to scheduled appointments, including coverage details, copays, deductibles, and prior authorization requirements
- Obtain prior authorizations for surgical procedures, DME, and diagnostic services as required by payer guidelines
- Submit clean claims to commercial and government payers (Medicare, Medicaid, workers comp) using practice management systems
- Review and resolve claim rejections and denials; prepare and submit appeals with supporting documentation
- Post insurance and patient payments accurately; reconcile EOBs/ERAs against expected reimbursement




- Manage accounts receivable aging; follow up on outstanding claims within payer-specific timely filing deadlines
- Communicate with insurance companies, patients, and provider offices to resolve billing discrepancies
- Maintain accurate patient demographic and insurance information in the practice management system
- Generate and review billing reports; track KPIs including days in AR, clean claim rate, and denial rate
- Ensure compliance with HIPAA, CMS, and payer-specific billing regulations

REQUIREMENTS
- 2+ years of medical billing and/or eligibility verification experience in a US healthcare setting
- Hands-on experience with insurance eligibility verification, benefits breakdown, and prior authorization workflows
- Working knowledge of ICD-10, CPT, and HCPCS code sets as they relate to billing and claim submission
- Familiarity with Medicare, Medicaid, and commercial payer billing rules and reimbursement methodologies

📌 Medical Biller (Bengaluru)
🏢 Sprocketinternational
📍 Bengaluru