Qureos Mentor

AltuMed (Cube Healthcare Systems Pvt Ltd)

The Senior Billing Executive is responsible for managing various aspects of the medical billing cycle, including accurate entry of patient demographics, insurance details, and billing data, as well as handling rejections, denials, follow-ups, appeals, and patient statements within the practice management system. The role also includes claim submissions, payment posting, eligibility verification, and coordination with payers, providers, and patients under the direction of the Team Lead Operations.This position requires advanced knowledge of revenue cycle management (RCM) processes and plays a key role in ensuring accurate and timely reimbursement. The Senior Billing Executive is also expected to mentor junior billing staff, provide feedback on process improvements, and support quality assurance initiatives.The role demands strong attention to detail, adherence to healthcare compliance standards (HIPAA, CMS, payer guidelines), problem-solving abilities, and effective communication skills to coordinate with internal teams and external stakeholders.This role not only provides essential exposure to complex billing operations but also offers growth opportunities within the RCM and compliance functions.Responsibilities:&middot; Independently perform and manage all activities of the medical billing cycle for assigned client(s), maintaining up-to-date knowledge of client \ practice \ specialty specific instructions.&middot; Verify patient demographics and insurance information in the practice management system at the time of charge entry to ensure accuracy. Provide feedback to front office staff for timely resolution.&middot; Maintain through knowledge of insurance guidelines, including HMO, PPO, Medicare, and state Medicaid. Perform eligibility and benefits verification, and obtain referrals and pre-authorizations as required.&middot; Accurately input all office and hospital charges into the practice management system in line with practice protocols. Ensure all charge batches balance in both the number of procedures and total dollar amounts prior to posting.&middot; Review physician coding at charge entry to ensure compliance with Medicare and payer guidelines for accurate, timely reimbursement.&middot; Post all payments (co-payments, insurance payments, and patient payments) by line item into the practice management system. Ensure payment batches balance before posting.&middot; Post all credit and debit adjustments to patient accounts in accordance with established guidelines.&middot; Track all submitted claims, verify submissions with clearinghouse and payer acceptance reports, and address all rejections and denials promptly.&middot; File all charges, payments (EOBs), and adjustment batches in the appropriate format by batch date for quick reference.&middot; Follow up regularly and effectively on all outstanding insurance claims to maximize collections and client satisfaction.&middot; Contact insurance companies daily to follow up on returned claims, denials, and account reconciliations. Ensure rebills are completed within five business days.&middot; Take timely corrective actions on denied claims, including research, analysis, and appeals as required.&middot; Communicate independently with insurance companies to maintain steady client cash flow and resolve payment discrepancies.&middot; Manage AR buckets and days in AR according to industry standards, working toward positive results against client KPIs.&middot; Review patient balances for accuracy prior to generating statements. Handle patient queries effectively and highlight past-due balances when confirming new appointments. Maintain patient confidentiality at all times.&middot; Provide customer service to patients and authorized representatives regarding accounts receivable. Return patient calls within two business days to ensure satisfaction.&middot; Notify billing software department of any updates required in fee schedules, billing processes, or system setups.&middot; Maintain effective written and verbal communication with providers, front desk staff, supervisors, and team members to ensure smooth operations.&middot; Prepare and present reports as required by clients or management.&middot; Ensure quality, timeliness, and accuracy throughout the billing cycle, in alignment with client and management standards.&middot; Maintain a professional, organized, and efficient work environment while strictly adhering to HIPAA rules and confidentiality requirements.&middot; Keep supervisors informed of important client-related issues.&middot; Perform additional duties as requested by supervisors or management.Education &amp; Experience Requirements:<ul><li>Bachelor&rsquo;s or Master&rsquo;s Degree in any field of study.</li><li>Candidates with at least 2 to 3 years of experience in the medical billing industry are encouraged to apply.</li><li>Comfortable working in a target-driven environment.</li></ul>Skills: <ul><li>Strong domain knowledge of the US healthcare industry</li><li>Good typing skills with basic proficiency in Microsoft office applications (Word, Excel, Outlook, etc.)</li><li>Ability to work effectively under pressure while consistently meeting deadlines.</li><li>Excellent Interpersonal and communication skills with the ability to collaborate as a strong team player.</li><li>Detail-oriented, well-organized and result-driven professional approach.</li></ul>Benefits:Market-Leading Salary, Medical insurance, Provident fund, EOBI, Paid Leaves, cash advance, Employee Performance based bonuses, Annual increments, Allowances ( Accommodation, OPD, Travel, Night, utilities, Technical ), Parental Leaves, Annual dinners &amp; tripsNote: Preference will be given to candidates from Hazara Division, KPK for this specific role. However, candidates from all over the Pakistan are welcomed.Job Type: Full-timeWork Location: In person

Sr. Billing Executive

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AltuMed (Cube Healthcare Systems Pvt Ltd)

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Sr. Billing Executive