Job Description

ModuleMD is a leading SaaS for medical practices in the US. Our solutions include an all-in-one Practice management, Electronic Health Records, and Revenue Cycle Management software together with a Managed Billing Service. We are looking for an experienced Billing Specialist / Senior Billing Specialist to join our team in India.

Company      : ModuleMD Healthcare Solutions Pvt Ltd (website:https://www.modulemd.com)

Job Title       : Billing Specialist / Senior Billing Specialist

Location        : Hyderabad (Currently work from home)

Experience    :  5 years to 10 years

Shift             : US hours – Night shift (5:30 Pm TO 2:30 Am IST)

Joining          : As early as possible

Role              : Permanent position

Education      : Bachelors’ Degree in related field or equivalent experience.

Experience:

Candidates must have 5+ Years of experience in accounts receivable follow-up / denial management especially a work experience on [claims Denials / Rejections] for US healthcare customers – MUST.

Working experience on websites like CHAMPS, Medicaid, Medicare etc.

Work Experience on Aging Analysis Report, Code Sets, Medicaid eligibility etc.

Should and must have work experience to know the purpose of the ABN, COB, and How to complete a Medicare reconsideration/appeal, the birthday rule, using CHAMPS website etc.

Experience in denials management and A/R fundamentals, Rejections and Appeals -MUST

Understanding of ICD-10 and CPT codes -MUST

Familiarity with multiple insurance web sites for eligibility, claims status, payments, disputes -MUST.

A very good practical working knowledge to know what information is to be included when an appeal is made for a claim.

HIPAA rules and regulations – privacy laws, access, and release of information

Ability to read and understand EOBs/Payment Vouchers -MUST

Experience in Allergy and Oncology preferred!

Excellent oral and writing communication abilities as well as call center expertise.

Ability to work independently, as well as a collaborative team player, in a remote setting.

Attention to detail.

Agile mindset: versatility, flexibility, and a willingness to enthusiastically work within constantly shifting priorities.

Responsibilities:

Maintain adequate documentation on the client software to send necessary documentation to insurance companies and maintain a clear audit trail for future reference.

Directly communicate with practices

Post payments as required.

Denials management A/R follow-ups: Perform analysis of accounts receivable data and understand the reasons for underpayment days in A/R top denial reasons use appropriate codes to be used in documentation of the reasons for denials / underpayments. MUST

Record after-call actions and perform post call analysis for the claim follow-up. MUST

Comply with terms of employment contract and company policies and procedures.

ModuleMD is an equal opportunity employer. We are dedicated to creating an inclusive, close-knit work environment where everyone is encouraged to be a part of the collaborative process and use individual strengths to shape their role at the company.

Interested candidates apply for this job or you can send your CV to:

Email ID: [email protected]

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