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 perks 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, perks 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