Billing Rejection Specialist

This is a fully remote position, open to applicants in India.

📋 Description

• Conduct daily reviews and manage clearinghouse portals to capture, categorize, and act upon front-end rejections.

• Reach out to insurance companies through phone or web portals to probe into intricate claim rejections, confirm active patient eligibility, and verify benefit coverage specifics.

• Analyze the root causes of claim rejections, such as demographic inaccuracies, absent insurance information, coding errors, and mismatches in provider credentialing.

• Make updates and corrections to patient demographics, insurance policy numbers, CPT/ICD-10 codes, and modifiers within practice management or EHR software prior to resubmitting claims.

• Collaborate with internal teams and medical coders to resolve data capture mistakes and assist in preventing repeated rejections.

• Keep detailed records of rejected claims, highlight common rejection patterns, and monitor resolution turnaround times, providing transparency to billing management.

⛳️ Requirements

• 1 to 3 years of relevant experience in medical billing, revenue cycle operations, or high-volume healthcare administration.

• Practical knowledge of major clearinghouses and electronic health record (EHR) / practice management software, including Waystar, Cortex, Epic, Athenahealth, eClinicalWorks, and NextGen.

• Exceptional attention to detail along with strong alphanumeric data entry and verification abilities.

• A solid foundational understanding of medical terminology, health insurance frameworks (Medicare, Medicaid, Commercial), and CMS-1500 claim formats.

• Excellent telephone etiquette and interpersonal communication skills for efficient payer outreach.

• Analytical skills to independently diagnose billing errors.

• Proven ability and dedication to consistently work the night shift schedule from 6:00 PM to 3:00 AM IST.

• High school diploma or equivalent is required.

🏝️ Benefits

• Comprehensive health insurance plans.

• Retirement savings options with employer match.

• Paid time off and holiday pay.

• Opportunities for professional development and advancement.