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Billing Rejection Specialist
Investigate and correct rejected medical claims, then resubmit them for processing. Monitor clearinghouses and contact payers to support healthcare revenue cycle operations.
Tavsif
- Review clearinghouse portals each day to identify, sort, and handle front-end claim rejections.
- Contact insurers by phone or through web portals to investigate complex rejections, confirm patient eligibility, and verify benefit coverage.
- Find the causes of rejected claims, such as demographic or insurance data errors, coding discrepancies, and provider credentialing mismatches.
- Correct patient demographics, policy numbers, CPT/ICD-10 codes, and modifiers in practice management or EHR software before resubmitting claims.
- Work with internal teams and medical coders to resolve data capture errors and reduce recurring rejections.
- Track rejected claims, rejection patterns, and resolution times to keep billing management informed.
Talablar
- Bring 1–3 years of experience in medical billing, revenue cycle operations, or high-volume healthcare administration.
- Have practical familiarity with major clearinghouses and EHR or practice management systems such as Waystar, Cortex, Epic, Athenahealth, eClinicalWorks, or NextGen.
- Demonstrate strong attention to detail and accurate alphanumeric data entry and verification skills.
- Understand medical terminology, Medicare, Medicaid and commercial insurance, and CMS-1500 claim formats.
- Communicate professionally by phone and with payer representatives.
- Be able to independently analyze and diagnose billing errors.
- Be able and committed to working the regular night shift from 6:00 PM to 3:00 AM IST.
- Have a high school diploma or equivalent.
- An associate degree or general background in healthcare administration or medical billing is preferred.
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