Insurance Claims & Denials Resolution Associate-Medical Billing

Key ResponsibilitiesAccounts Receivable & Denials Management

• Monitor and manage outstanding insurance claims to reduce overall Accounts Receivable (AR) balances.
• Review and resolve claim denials on a daily basis, ensuring prompt and accurate follow-up.
• Analyze Electronic Remittance Advice (ERA) data to identify recurring denial patterns and recommend corrective measures.
• Prepare, submit, and track appeals for denied or underpaid claims with appropriate documentation.
• Investigate and resolve payment discrepancies, escalating complex cases to the Billing Manager as needed.
• Maintain and update AR aging reports, providing regular weekly and monthly performance updates.
• Process claims for specialized services, including TMS, Spravato, and psychological testing.
• Collaborate closely with the Billing Manager to meet AR resolution and collection goals.

Patient & Provider Support

• Respond to billing-related inquiries from patients, providers, and internal teams in a timely manner.
• Review and update patient accounts to ensure accuracy prior to initiating collection actions.
• Work with providers to correct claim errors, including coding and supporting documentation.
• Coordinate with insurance payers regarding prior authorizations, coverage verification, and network participation.
• Address patient billing concerns professionally and process refunds where appropriate.

System Support & Process Improvement

• Submit and monitor support tickets in eClinicalWorks (eCW) to resolve billing-related issues efficiently.
• Provide training and support to team members on AR and denial management workflows.
• Partner with U.S.-based teams to ensure timely and accurate claim submissions.
• Participate in team meetings to review AR performance, identify trends, and recommend process improvements.
• Stay current with payer policies, compliance regulations, and medical billing best practices.

Job Type: Full-time

Pay: Rs40,000.00 - Rs70,000.00 per month

Ability to commute/relocate:

• Lahore: Reliably commute or planning to relocate before starting work (Required)

Application Question(s):

• Willing to work the night shift?

Experience:

• Medical Billing: 1 year (Preferred)

Language:

• English (Required)

Work Location: In person