Responsibilities
- Review and validate medical claims submissions for accuracy and completeness
- Analyze approved, pending, and denied claims, ensuring proper follow-up and resolution
- Refile or correct claims based on denial reasons (coding issues, eligibility, authorization, etc.)
- Ensure patient billing accuracy, including adjustments and corrections
- Audit and validate payment postings in EHR systems
- Ensure alignment between EOB/ERA and posted transactions
- Identify discrepancies and escalate or resolve accordingly
- Investigate root causes of claim denials
- Recommend corrective actions to prevent recurring issues
- Track and manage denial trends and ensure timely resolution
- Perform high-volume, accurate data entry and documentation
- Maintain organized records within client systems
- Conduct quality checks to ensure compliance with client standards
- Work directly with the US-based client stakeholders
- Provide updates, insights, and recommendations on claims performance
- Demonstrate supervisor-level ownership and decision-making
- Identify inefficiencies and suggest process improvements
- Act as a subject matter expert (SME) in claims and billing workflows
- Support documentation and standardization of processes
Requirements
- strong accountability
- critical thinking
- process ownership
Benefits
- 21K Signing Bonus
Team
Structure: Supervisor-Level, Individual Contributor
