Role & responsibilities
Manage the complete US healthcare medical billing and revenue cycle management (RCM) process.
Review and submit accurate medical claims to insurance companies through clearinghouses.
Perform insurance verification, eligibility checks, charge entry, payment posting, and claim follow-up.
Investigate and resolve claim denials, rejections, underpayments, and payment discrepancies.
Prepare and submit appeals, reconsiderations, and corrected claims based on payer requirements.
Review EOBs, ERAs, CPT, HCPCS, and ICD-10-CM codes for billing accuracy.
Identify recurring denial trends and take corrective action to reduce AR days and denial rates.