Job Description :

• Claims Follow-Up Executive US Medical Billing

  Candidate Application: 

  Full Name: 

  Contact Number: 

  Email Address: 

  Current Location: 

  Position Applied For: 

  Qualification:  

  Year of Passout: 

  Candidate Category: Fresher / Experienced

  Willingness to Relocate: Yes / No

   

  Total Years of Experience: (If applicable) 

  Current/Last Drawn Salary (Monthly/Annual): 

  Notice Period:

   

  Job Description:

  Responsibilities:

  Payer Follow-Up & Outstanding Claim Resolution: Start verbal and online follow-ups with US government and commercial insurance providers about unpaid, underpaid, pending, or rejected medical claims that are more than 30 days old.

  Denial Management & fundamental Cause Analysis: To determine the fundamental reasons of denials and carry out focused corrective activities, examine Claim Adjustment Reason Codes (CARC) and Remittance Advice Remark Codes (RARC).

  Appeals Drafting & Re-submission: Compile clinical records, draft formal appeal letters, including supporting CPT/ICD-10 coding records, and resubmit amended claims within the payer-mandated Timely Filing Limits (TFL).

  Payer Policy & Navigation on the Web Portal: Use the main insurance payer portals to upload necessary paperwork, confirm patient benefits, and check the status of claims in real time.

   

  Required Skills: 

  Explanation of Benefits (EOBs), insurance plans, Electronic Remittance Advices (ERAs), CARC/RARC denial codes, and timely filing limits are all part of the US healthcare system.

  Verbal Negotiation & Call Etiquette: Excellent pronunciation of spoken English, professional phone manners, attentive listening, and the perseverance required to deal with payer Interactive Voice Response (IVR) systems and claims agents.

  Practice Management & RCM Software Proficiency: Practical knowledge of clearinghouse management portals and medical billing software.

  Denial Troubleshooting & Analytical Problem-Solving: The capacity to swiftly decipher medical necessity regulations, examine coding and billing mistakes, and develop rational appeal tactics.

   

  Experience: 0 to 3 yrs

  Salary: Best in the Industries

   

  Immediate Joiner Mostly Preferred

  Interested Candidates Contact the HR ASAP

  Warm Regards,

  HR - Maria

  88708 33430

  infohrmaria04@gmail.com