Medical Billing Executive US Healthcare | Claims | AR | Denial Management

Company: Spark Techwave InnovationZ Pvt Ltd
Job Type: Full-Time
Experience: 1-5 Years
Location: Chennai / Remote / Hybrid
Department: Healthcare Operations / Medical Billing

Job Summary

Spark Techwave InnovationZ Pvt Ltd is looking for a Medical Billing Executive with experience in US healthcare medical billing and revenue cycle management.

The candidate will be responsible for claim processing, payment posting, accounts receivable follow-up, denial management, insurance verification, and resolving billing-related issues to ensure timely and accurate reimbursement.

Key Responsibilities

- Process and submit medical claims to insurance companies and payers.
- Review claims for accuracy and completeness before submission.
- Perform insurance verification and eligibility checks.
- Handle claim status follow-up with insurance companies.
- Work on Accounts Receivable (AR) and outstanding claims.
- Analyze and resolve claim denials and rejections.
- Perform payment posting and reconciliation.
- Identify billing discrepancies and take corrective action.
- Follow up on underpaid, unpaid, and rejected claims.
- Handle insurance and patient billing-related queries.
- Maintain accurate records of claims, payments, denials, and follow-ups.
- Review Explanation of Benefits (EOB) and Electronic Remittance Advice (ERA).
- Coordinate with internal teams, healthcare providers, and insurance companies when required.
- Maintain productivity, quality, and accuracy standards.
- Follow HIPAA and applicable healthcare data privacy requirements.
- Prepare regular billing and AR status reports.

Required Skills

- 15 years of experience in US Medical Billing / Healthcare RCM.
- Understanding of the US healthcare revenue cycle.
- Knowledge of:

- Medical Claims
- Insurance Verification
- Eligibility Verification
- AR Follow-up
- Denial Management
- Payment Posting
- Claim Submission
- Claim Rejection
- EOB / ERA





- Basic understanding of ICD-10, CPT, and HCPCS codes.
- Knowledge of US insurance payers and healthcare billing processes.
- Good knowledge of MS Excel.
- Strong attention to detail and accuracy.
- Good written and verbal communication skills.
- Ability to work with deadlines and productivity targets.

Good to Have

- Experience with US Healthcare RCM.
- Experience working with Medicare and Medicaid claims.
- Knowledge of commercial insurance payers.
- Experience with denial codes and appeals.
- Knowledge of HIPAA regulations.
- Experience with medical billing/RCM software.
- Knowledge of clearinghouses and electronic claim submission.
- Experience in healthcare BPO/KPO operations.
- Experience with physician billing or hospital billing.

Education

- Any Bachelor's degree or equivalent qualification.
- Healthcare/medical billing certification is an advantage but not mandatory.

Preferred Candidate Profile

- Candidates with hands-on US medical billing or RCM experience.
- Solid attention to detail and numerical accuracy.
- Good communication and follow-up skills.
- Ability to analyze claim issues and identify appropriate resolution.
- Comfortable working with healthcare billing systems and payer portals.
- Ability to work independently and as part of a team.

Key Skills for Naukri

Medical Billing, US Medical Billing, Healthcare RCM, Revenue Cycle Management, Medical Claims, Claims Processing, AR Follow Up, Accounts Receivable, Denial Management, Payment Posting, Insurance Verification, Eligibility Verification, EOB, ERA, ICD-10, CPT, HCPCS, US Healthcare, Claims Submission, Claims Rejection, Medical Coding, HIPAA

Suggested Naukri Job Titles

- Medical Billing Executive
- Medical Billing Specialist
- US Medical Billing Executive
- Medical Billing Analyst
- Healthcare RCM Executive
- RCM Executive
- Medical Claims Executive
- AR Caller – US Healthcare
- Medical Billing Specialist – US Healthcare
- Healthcare Revenue Cycle Executive

Send your resume at [email protected]

📌 Medical Billing Executive (India)
🏢 Spark Tech Wave Innovation
📍 India