Medical Billing Specialist

13 hours ago


Lahore, Punjab, Pakistan HRMD Solutions Full time

Job Description:

The AR Follow-up Specialist plays a critical role in managing and collecting outstanding accounts receivable within the revenue cycle management process. This position requires fluency in English to effectively communicate with our diverse client base. The ideal candidate will have a strong background in collections within the healthcare industry in the USA, exceptional communication skills, and the ability to work independently in a fast-paced environment.

  • Key Responsibilities:
  • Verify patient eligibility and benefit verification through calls and web portals.
  • Review and verify medical codes, including CPT, ICD-10, and HCPCS.
  • Transmit corrected claims electronically or by paper according to payers' requirements.
  • Monitor and follow up on unpaid or denied claims to ensure timely resolution.
  • Contact insurance companies to inquire about claims status and facilitate payment.
  • Review aging reports regularly to prioritize and address delinquent accounts.
  • Initiate appeals for denied or underpaid claims and track the appeal process.
  • Develop denial management strategies to minimize future denials.
  • Maintain detailed records of appeals.
  • Understand insurance policies, reimbursement methodologies, and billing guidelines.
  • Collaborate with billing and coding teams to address recurring issues.
  • Investigate and resolve discrepancies in payments, adjustments, or denials.
  • Identify claim processing issues and general billing trends.

Requirements:

  • Bachelor's Degree from a reputable institution or university.
  • 1 to 2 years' experience in medical billing - accounts receivable and denial management.
  • Knowledge and understanding of USA health insurance guidelines, especially Medicare and state Medicaid.
  • Experience in Pain Management, Lab, Anesthesia, Psych/TMS, RTM, CCM.
  • Strong communication skills are essential.
  • Must have a strong grip on MS Office.


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