Medical Biller Job Profile (Night Shift)

Position: Medical Biller Eligibility Verification, AR & Denial Management

Company: AdeptMed

Location: JMD

Department: Medical Billing / Revenue Cycle Management (RCM)

Job Summary The Medical Biller will be responsible for managing key revenue cycle functions, including insurance eligibility verification, claims processing, payer follow-up, accounts receivable (AR), payment posting, and claims denial management. The ideal candidate should have strong knowledge of healthcare billing processes, payer guidelines, and revenue cycle workflows, with the ability to identify and resolve claim issues efficiently.

Key Responsibilities

- Perform insurance eligibility and benefits verification before patient services.
- Verify patient demographics, insurance information, coverage dates, deductibles, copays, and authorization requirements.
- Submit clean and accurate medical claims to commercial, Medicare, Medicaid, and other payers.
- Review claims for billing errors, missing information, coding issues, and payer-specific requirements.
- Manage payer accounts receivable (AR) and conduct timely follow-up on outstanding claims.
- Contact insurance companies regarding unpaid, underpaid, rejected, and pending claims.
- Analyze AR aging reports and prioritize accounts based on age, balance, and payer.
- Research and resolve claim denials, rejections, and underpayments.
- Identify denial root causes and take corrective action to prevent recurring denials.
- Prepare and submit claim appeals with appropriate documentation and supporting information.
- Follow up on appealed claims and maintain accurate documentation of payer communications.
- Work on authorization, medical necessity, eligibility, timely filing, coding, and documentation-related denials.
- Post insurance and patient payments accurately when required.
- Reconcile accounts and identify discrepancies between payments, EOBs/ERAs, and billed amounts.




- Maintain accurate billing records and follow HIPAA and company compliance requirements.
- Meet productivity, quality, collection, and turnaround-time targets.
- Communicate effectively with insurance representatives, healthcare providers, and internal billing teams.

Required Skills & Knowledge

- Solid understanding of US healthcare medical billing and Revenue Cycle Management (RCM).
- Experience with Eligibility Verification.
- Knowledge of Payer AR / Accounts Receivable follow-up.
- Strong Claims Denial Management experience.
- Knowledge of claim submission, rejection correction, appeals, and reconsiderations.
- Understanding of EOBs, ERAs, CPT, ICD-10-CM, HCPCS, modifiers, and payer policies.
- Ability to interpret denial codes and determine appropriate resolution.
- Strong analytical and problem-solving skills.
- Excellent communication and follow-up skills.
- Proficiency with medical billing software, payer portals, and Microsoft Office.
- Ability to work independently while meeting daily productivity and quality goals.

Preferred Experience

- 13+ years of experience in medical billing, AR, claims, eligibility, or denial management.
- Experience working with multiple US healthcare insurance payers.
- Experience with payer portals and clearinghouses.
- Experience handling high-volume AR and denial accounts.
- Experience with denial trend analysis and root-cause identification.

Key Performance Indicators (KPIs)

- AR follow-up productivity
- Claim resolution rate
- Denial resolution rate
- Clean claim rate
- First-pass claim acceptance
- AR aging reduction
- Appeal success rate
- Collection rate
- Eligibility verification accuracy
- Quality and turnaround time

Ideal Candidate Profile AdeptMed is looking for a detail-oriented Medical Billing / AR Specialist who understands the complete billing cycle—from eligibility verification and claim submission through payer follow-up, AR resolution, and denial management. The candidate should be persistent, analytical, and comfortable communicating with insurance payers to maximize timely and accurate reimbursement.

Adeptmed.in

Email Resume At :[email protected]

📌 Walk-in || Medical Biller Eligibility Verification, AR & Denial Management (Gurugram)
🏢 Daksh Shaunak
📍 Gurugram