Job Summary:
We are seeking a proactive Medical Billing Executive. In this role, you will manage insurance verifications, process claims, handle follow-ups with insurance providers and patients, and resolve discrepancies. A solid understanding of Medicare, Medicaid, and multi-specialty billing is required. The ideal candidate will have excellent communication skills and attention to detail, ensuring timely and accurate billing processes.
Responsibilities:
- Eligibility & Benefits Verification: Verify patient eligibility and benefits by making phone calls and accessing web portals to ensure accurate insurance coverage before proceeding with any treatments or procedures.
- Claims Preparation & Submission: Prepare, review, and submit claims using billing software, ensuring that both electronic and paper claims are processed correctly. Additionally, identify secondary and tertiary insurance carriers and submit claims accordingly to ensure maximum reimbursement.
- Payment Accuracy & Compliance: Review insurance payments for accuracy, ensuring they comply with the agreed contract discounts. Post payments accurately into the billing software using EOB/ERA data to maintain precise records.
- Patient Billing Review: Review patient bills for accuracy, ensuring all charges are correctly applied and complete. Follow up on any missing information from patients or insurance companies, and generate patient statements to collect outstanding balances.
- Referrals & Pre-authorizations: Ensure all necessary referrals and pre-authorizations are obtained from insurance companies before proceeding with any procedures or treatments, ensuring no delays in the billing process.
- Discrepancy Resolution: When discrepancies in payments occur, promptly contact insurance companies to resolve the issues, ensuring timely corrections and preventing delayed payments.
- Account Follow-up: Review all accounts to ensure that both insurance and patient follow-up are conducted thoroughly. Regularly follow up on unpaid claims through phone calls to insurance companies and by checking web portals for updates.
- Claims Research & Appeals: Conduct research on denied claims, identifying the cause and resolving the issues in a timely manner. Appeal denied claims with appropriate documentation to ensure that reimbursements are maximized.
- Fee Schedule Updates: Ensure that billing software is updated to reflect any changes in the fee schedule or insurance contract terms. This guarantees compliance with the most current rates and prevents discrepancies.
- Cash Management & Reporting: Maintain and update cash spreadsheets to track payments and outstanding balances. Generate collection reports for internal tracking and to monitor cash flow.
- Patient & Insurance Inquiries: Professionally handle and respond to patient or insurance inquiries related to assigned accounts, ensuring clear communication and timely resolutions to any questions or issues.
Requirements:
- Bachelor’s Degree from a recognized institute or university.
- 6 months to 2 years of experience in Medical Billing/Accounts Receivable (AR).
- Hands-on experience with appeals, follow-up, insurance calls, and patient calls.
- Strong understanding of USA health insurance guidelines, especially Medicare and state Medicaid.
- Experience working with multiple specialties in medical billing.
- Excellent verbal and written communication skills in English
Employee Benefits:
- Performance-based rewards
- Employee Health Insurance
- Leave Encashment
- Office Gatherings, Celebrations, and Trips
- 5 days a week. (work-life balance)
- Provident Fund
- Travelling Allowance
