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Macrise Tech Solutions

We are looking for a highly organized and detail-focused Insurance Verification &amp; Authorization Specialist to join our medical billing team. This role is essential in ensuring accurate patient insurance verification, securing timely prior authorizations, and maintaining complete and compliant documentation to support efficient billing and claims processing.The ideal candidate will possess strong communication skills, exceptional attention to detail, and a thorough understanding of payer requirements, with the ability to perform effectively in a fast-paced healthcare environment.Key ResponsibilitiesInsurance Verification &amp; Eligibility<ul><li>Verify patient insurance coverage through payer portals and direct communication with insurance providers.</li><li>Maintain accurate and up-to-date eligibility records within the Electronic Health Record (EHR) system (e.g., eClinicalWorks).</li><li>Complete and upload insurance verification documentation promptly for all newly registered patients.</li><li>Clearly explain estimated patient financial responsibilities, including copayments, deductibles, and out-of-pocket expenses.</li><li>Escalate unresolved eligibility discrepancies or coverage issues to the Patient Collections team when required.</li><li>Proactively follow up with patients to obtain missing, corrected, or updated insurance information.</li></ul>Authorizations &amp; Compliance<ul><li>Obtain prior authorizations for medical and behavioral health services requiring insurance approval.</li><li>Ensure compliance with Medicaid and other payer-specific authorization guidelines and policies.</li><li>Coordinate with the Patient Services team to manage out-of-network insurance cases.</li><li>Secure authorizations for psychological assessments while maintaining accurate documentation and system alerts.</li></ul>Operational Support &amp; Collaboration<ul><li>Assist with urgent or same-day appointment scheduling as needed.</li><li>Track and communicate updates related to payer policies, billing concerns, and provider network participation.</li><li>Collaborate with the Practice Manager to resolve incomplete or inaccurate patient intake documentation.</li><li>Participate in team meetings to enhance workflow efficiency, improve data accuracy, and support continuous process improvement.</li></ul>Job Type: Full-timePay: Rs45,000.00 - Rs70,000.00 per monthAbility to commute/relocate:<ul><li>Wapda Town: Reliably commute or planning to relocate before starting work (Required)</li></ul>Application Question(s):<ul><li>Willing to work the night shift in Wapda Town, Lahore?</li></ul>Experience:<ul><li>Medical Billing: 1 year (Preferred)</li></ul>Language:<ul><li>English (Required)</li></ul>Work Location: In person

Insurance Verification (VOB)-Medical Billing

Patient Communication &amp; Call Management<ul><li>Conduct outbound calls and send follow-up communications to patients regarding outstanding balances, payment reminders, and billing inquiries.</li><li>Handle inbound patient calls related to billing statements, account balances, payment arrangements, and general billing questions.</li><li>Communicate with patients in a clear, professional, and empathetic manner to address concerns and provide accurate billing information.</li></ul>Billing &amp; Payment Processing<ul><li>Accurately post patient and insurance payments within the billing system.</li><li>Process manual receipts and ensure all financial transactions are properly recorded and documented.</li><li>Generate and distribute electronic billing statements (e-Statements) to patients in a timely manner.</li><li>Establish, monitor, and manage patient payment plans in accordance with organizational policies.</li><li>Process scheduled payment plan charges and ensure accurate transaction posting.</li></ul>Account Management<ul><li>Identify and resolve account discrepancies by reviewing posting errors and performing necessary balance adjustments.</li><li>Review and update patient account information to maintain accuracy throughout the billing lifecycle.</li><li>Ensure all billing-related activities are properly documented and traceable within the system.</li></ul>Encounter &amp; Documentation Management<ul><li>Review patient encounters to confirm that charges are accurately entered and aligned with services provided.</li><li>Coordinate with internal teams to resolve missing, incomplete, or inaccurate encounter information.</li><li>Maintain organized, accurate, and up-to-date billing documentation within the practice management system.</li></ul>Job Type: Full-timePay: Rs45,000.00 - Rs70,000.00 per monthAbility to commute/relocate:<ul><li>Wapda Town: Reliably commute or planning to relocate before starting work (Required)</li></ul>Application Question(s):<ul><li>Willing to work the night shift in Wapda Town, Lahore?</li></ul>Experience:<ul><li>Medical Billing: 1 year (Required)</li></ul>Language:<ul><li>English (Required)</li></ul>Work Location: In person

Patient Collection & Patient Calling-Medical Billing

Job Description: Accounts Receivable &amp; Denial Management<ul><li>Monitor and manage outstanding insurance claims to support the reduction of overall Accounts Receivable (AR) balances.</li><li>Conduct regular follow-ups on denied claims to ensure timely resolution and maximize claim recovery.</li><li>Analyze Electronic Remittance Advice (ERA) reports to identify recurring denial trends and recommend corrective measures.</li><li>Prepare, submit, and track appeals for denied or underpaid claims, ensuring all supporting documentation is accurate and complete.</li><li>Investigate payment discrepancies and escalate complex or unresolved issues to the Billing Manager as needed.</li><li>Maintain up-to-date AR aging reports and provide consistent weekly and monthly performance updates.</li><li>Manage billing and claims processing for specialized services, including TMS, Spravato, and psychological assessments.</li><li>Collaborate with the Billing Manager to achieve AR reduction, recovery, and accuracy targets.</li></ul>Patient &amp; Provider Communication<ul><li>Respond promptly and professionally to billing-related inquiries from patients, providers, and internal teams.</li><li>Review and validate patient account information prior to initiating collections or claim follow-ups.</li><li>Work closely with providers to resolve claim issues, including coding discrepancies and missing documentation.</li><li>Communicate with insurance payers regarding eligibility, prior authorizations, and network participation.</li><li>Address patient concerns with professionalism and empathy, including processing refunds when appropriate.</li></ul>Systems Management &amp; Process Improvement<ul><li>Create, monitor, and resolve billing-related support tickets within the eClinicalWorks (eCW) system.</li><li>Provide guidance and support to team members on AR follow-up strategies and denial resolution processes.</li><li>Coordinate with U.S.-based billing teams to ensure accurate and timely claim submissions.</li><li>Participate in operational meetings to review performance trends and recommend process improvements.</li><li>Stay informed on payer policies, regulatory requirements, and industry best practices in medical billing and reimbursement.</li></ul>Job Type: Full-timePay: Rs45,000.00 - Rs70,000.00 per monthAbility to commute/relocate:<ul><li>Wapda Town: Reliably commute or planning to relocate before starting work (Required)</li></ul>Application Question(s):<ul><li>Willing to work the night shift in Wapda Town, Lahore?</li></ul>Experience:<ul><li>AR: 1 year (Preferred)</li></ul>Language:<ul><li>English (Required)</li></ul>Work Location: In person

Medical Billing Denials & Appeals Specialist

The Credentialing Specialist is responsible for overseeing the full lifecycle of provider credentialing and re-credentialing across multiple insurance networks, payers, and credentialing platforms. This role requires a proactive and detail-oriented individual with strong follow-up skills to ensure continuous compliance with regulatory standards, uninterrupted provider participation, and smooth billing and authorization processes. The position plays a vital role in maintaining operational efficiency and supporting accurate and timely reimbursements.Key ResponsibilitiesCredentialing &amp; Compliance<ul><li>Maintain, organize, and routinely update provider credentialing records for both commercial and government payers.</li><li>Manage and monitor CAQH profiles to ensure alignment with CMS regulations and payer-specific credentialing requirements.</li><li>Process initial credentialing, re-credentialing, and payer enrollment applications for Medicare, Medicaid, and commercial insurance networks.</li><li>Handle applications, renewals, and documentation related to professional licenses, DEA registrations, and controlled substance certifications.</li><li>Complete provider revalidation processes with government and regulatory agencies within defined timelines.</li><li>Coordinate hospital credentialing activities, including managing provider privileges and maintaining active affiliations.</li></ul>Collaboration &amp; Operational Support<ul><li>Partner with the Revenue Cycle Director and Billing Team to resolve credentialing-related denials, payer issues, and authorization delays.</li><li>Ensure accuracy and consistency of provider information across CAQH, PECOS, NPPES, CMS databases, and internal systems.</li><li>Maintain a centralized credentialing tracker, including provider credentials, expiration dates, payer participation status, and system access details.</li><li>Provide administrative support for credentialing audits, compliance reviews, and regulatory documentation as needed</li></ul>Job Type: Full-timePay: Rs45,000.00 - Rs80,000.00 per monthAbility to commute/relocate:<ul><li>Wapda Town: Reliably commute or planning to relocate before starting work (Required)</li></ul>Application Question(s):<ul><li>Willing to work the night shift in Wapda Town, Lahore?</li></ul>Experience:<ul><li>Credentialing: 1 year (Required)</li></ul>Language:<ul><li>English (Required)</li></ul>Work Location: In person

Credentialing & Provider Enrollments Executive-Medical Billing

Join Macrise Tech Solutions and explore 4   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

Macrise Tech Solutions

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Insurance Verification (VOB)-Medical Billing

Patient Collection & Patient Calling-Medical Billing

Medical Billing Denials & Appeals Specialist

Credentialing & Provider Enrollments Executive-Medical Billing