09 Sep
|
Office Beacon
|
Mandvi
09 Sep
Office Beacon
Mandvi
Job DescriptionJob Title: Medical Biller / Authorization & Administrative Support
NExperience Level: 2+ Years
NLocation: Vadodara, Gujarat, India / WFH
NShift Time: US Shift (10-hour shift including a 1-hour break)
NExperience Required
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- Minimum 2+ years of hands-on experience in medical billing, preferably within Medi-Cal managed care, behavioral health, or social services billing. N
- Hands-on experience with Office Ally for claims submission, eligibility verification, and ERA/EOB retrieval is strongly preferred. N
- Experience billing to IEHP or California Medi-Cal managed care plans will be an added advantage. N
- Familiarity with CalAIMCommunity Supports, including HTNS, HTSS, or similar services, is preferred. N
nKey Responsibilities
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- Prepare, review, and submit HTNS and HTSS claims through the Office Ally clearinghouse, ensuring accurate coding, units, authorization numbers, and member eligibility. N
- Monitor clearinghouse reports daily to identify claim acceptance, rejections, and required corrections. N
- Track claims from submission through adjudication and follow up on pending, denied, or underpaid claims. N
- Reconcile remittance advices (835s/EOBs) against expected reimbursement and accurately post payments and adjustments. N
- Research and resolve claim denials by identifying root causes such as authorization mismatches, eligibility gaps, and coding errors. N
- Maintain and update reauthorization trackers to ensure services are billed within active authorization periods. N
- Verify member Medi-Cal/IEHP eligibility prior to billing and flag discrepancies to the appropriate internal team. N
- Maintain accurate, organized, and audit-ready billing records in compliance with HIPAA and applicable privacy requirements. N
- Prepare weekly and monthly billing reports covering aging claims, denial trends, and collections. N
- Stay updated on IEHP authorization guidelines, CalAIM billing requirements, and Office Ally sys
📌 Hiring: Medical Biller (Mandvi)
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📍 Mandvi