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denial management specialist medical billing us healthcare

AppedologyPK Recruitment

<p>Job Summary:</p><p>We are seeking a detail-oriented and analytical professional to join our team as a Denial Management Specialist within the Medical/Behavioral Health domain. The primary responsibility of this role is to identify, analyze, and resolve claim denials to ensure accurate and timely reimbursement. The ideal candidate will possess a strong understanding of insurance processes, medical billing, and payer guidelines, particularly within behavioral health services. This position requires excellent problem-solving skills, attention to detail, and the ability to multitask effectively while maintaining a high level of accuracy and compliance. The candidate should also demonstrate strong communication abilities to coordinate with payers, clients, and internal teams for swift resolution of denied or underpaid claims.</p><p>Key Responsibilities:</p><ul><li>Review and analyze denied or underpaid medical and behavioral health claims to determine root causes.</li><li>Work with insurance companies to resolve denials and ensure timely and accurate reimbursement.</li><li>Identify recurring denial trends and collaborate with billing and clinical teams to prevent future occurrences.</li><li>Prepare and submit appeals with appropriate supporting documentation in accordance with payer requirements.</li><li>Maintain detailed records of denial activities, appeal statuses, and resolutions in the billing system.</li><li>Communicate effectively with payers, clients, and internal departments to ensure issues are addressed promptly.</li><li>Monitor claim status and follow up proactively to reduce outstanding accounts receivable.</li><li><b>Ensure compliance with all HIPAA, payer, and organizational policies during all denial management processes.</b></li></ul><p>Requirements:</p><ul><li>High school diploma or equivalent; associate&rsquo;s or bachelor&rsquo;s degree in accounting, finance, or a related field is a plus.</li><li>Proven experience in billing, accounting, or administrative roles.</li><li>Strong attention to detail and numerical accuracy.</li><li>Proficiency in Microsoft Excel and billing/accounting software.</li><li>Excellent communication and organizational skills.</li><li>Ability to work independently and meet deadlines.</li></ul><p>Job Type: Full-time</p>

Denial Management Specialist (MEDICAL BILLING US HEALTHCARE)

THE KIDNEY CENTRE

<p>The Kidney Centre is a centrally located specialty hospital, offering a collegial workplace experience with balanced work hours and competitive compensation packages. We invite applications from interested and suitably qualified candidates to fill the following position:</p><p><b>Position Overview:</b></p><p>We are currently seeking a detail-oriented and experienced <b>Medical Coder</b> to join our healthcare team. The ideal candidate will be responsible for reviewing clinical documentation and assigning accurate medical codes for diagnoses, procedures, and services, ensuring compliance with all regulations and optimizing reimbursements.</p><p><b>Key Responsibilities:</b></p><ul><li>Review and analyze patient medical records and documentation</li><li>Assign appropriate ICD-10, CPT, and HCPCS codes based on medical documentation</li><li>Ensure coding accuracy and compliance with federal regulations and insurance requirements</li><li>Collaborate with physicians, billing staff, and other healthcare providers to clarify diagnoses or obtain additional information</li><li>Assist in audits and provide coding education when needed</li><li>Maintain confidentiality of patient records and adhere to HIPAA regulations</li></ul><p><b>Qualifications:</b></p><ul><li>Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent certification required</li><li>Minimum [1-2] years of medical coding experience (preferred)</li><li>Strong knowledge of anatomy, physiology, and medical terminology</li><li>Experience with electronic medical records (EMR) and coding software</li><li>High attention to detail and accuracy</li><li>Excellent communication and organizational skills</li></ul><p>Interested candidates can apply at <b>careers@kidneycentre.com</b></p><p>Please mention the position applied for in the subject line, or you can submit it to the Human Resources Department. For inquiry Tel # 0213-5661000, Ext#271.</p><p>Job Types: Full-time, Contract</p><p>Work Location: In person</p>

Medical Coder

FIT Solutions

<p><b>Position:</b> Lien Negotiator &ndash; Workers&rsquo; Compensation Claim Collections (USA Healthcare)<br/><b>Location:</b> Onsite &ndash; Gulshan-e-Iqbal, Block 11, Karachi<br/><b>Shift Timings:</b> 8:00 PM to 5:00 AM (Night Shift)<br/><b>Company:</b> Fit Solutions</p><p><b>About Us:</b><br/>Fit Solutions is a leading healthcare outsourcing company providing professional services to U.S.-based clients. We specialize in medical billing, revenue cycle management, and claims negotiation. We&rsquo;re expanding our Workers&rsquo; Compensation team and looking for dedicated <b>Lien Negotiators</b> to join our growing operations.</p><p><b>Key Responsibilities:</b></p><ul><li>Negotiate medical liens related to Workers&rsquo; Compensation and Personal Injury claims with attorneys and insurance adjusters in the U.S.</li><li>Review claim files and supporting documentation to determine the best negotiation strategy.</li><li>Communicate effectively with clients, law firms, and third-party administrators to achieve settlement targets.</li><li>Maintain accurate records of negotiations and settlements.</li><li>Meet daily and monthly performance goals.</li></ul><p><b>Requirements:</b></p><ul><li>Excellent English communication and negotiation skills.</li><li>Prior experience in <b>Workers&rsquo; Compensation, Personal Injury, or Medical Billing</b> is preferred.</li><li>Strong analytical and multitasking abilities.</li><li>Proficiency in MS Office and CRM tools.</li><li>Ability to work independently during U.S. business hours.</li></ul><p><b>What We Offer:</b></p><ul><li>Competitive salary based on experience and performance.</li><li>Growth-oriented environment with continuous training.</li><li>Incentive-based performance rewards.</li><li>Friendly, professional workplace culture.</li></ul><p><b>Shift:</b> Night (8:00 PM &ndash; 5:00 AM, Pakistan Standard Time)<br/><b>Location:</b> Onsite &ndash; Gulshan-e-Iqbal, Block 11, Karachi</p><p><b>How to Apply:</b><br/>Interested candidates can apply by sending their resume to <b>hr@fitsolutions.pk</b> with the subject line <i>&ldquo;Lien Negotiator &ndash; Workers&rsquo; Comp Collections.&rdquo;</i></p><p>Job Type: Full-time</p><p>Pay: Rs50,000.00 - Rs80,000.00 per month</p><p>Work Location: In person</p>

Lien Negotiator

<p><b>Job Summary:</b><br/>The Medical Billing Associate is responsible for creating and processing accurate medical bills and claim forms (including HCFA/CMS-1500), ensuring compliance with payer requirements and coding standards. The role requires strong knowledge of CPT and ICD-10 codes, attention to detail, and an understanding of healthcare billing workflows to ensure timely and accurate claim submission and reimbursement.<b>Key Responsibilities:</b></p><ul><li>Prepare and generate accurate medical bills and HCFA (CMS-1500) claim forms based on patient encounters and medical documentation.</li><li>Review and validate patient demographics, provider details, insurance information, and service codes before claim creation.</li><li>Apply correct CPT, ICD-10, and HCPCS codes to ensure claims meet payer requirements.</li><li>Verify claim accuracy and completeness prior to submission to clearinghouses or payers.</li><li>Identify and correct billing errors to minimize claim rejections or denials.</li><li>Coordinate with the coding, charge entry, and AR teams to ensure accurate and timely billing.</li><li>Maintain compliance with HIPAA, CMS, and payer-specific billing regulations.</li><li>Assist in claim resubmissions, adjustments, and appeals when necessary.</li><li>Maintain organized billing records and documentation for audit and reporting purposes.</li></ul><p><b>Qualifications and Requirements:</b></p><ul><li>Bachelor&rsquo;s degree in Commerce, Healthcare Administration, or a related field (preferred).</li><li>1&ndash;3 years of experience in U.S. medical billing or revenue cycle operations.</li><li>Proficiency in preparing HCFA/CMS-1500 claim forms and using billing software (e.g., Kareo, AdvancedMD, eClinicalWorks, Athenahealth, or similar).</li><li>Understanding of CPT, ICD-10, and HCPCS coding systems.</li><li>Excellent attention to detail, analytical ability, and organizational skills.</li><li>Good communication and coordination skills for working with cross-functional teams.</li><li>Ability to work independently and meet deadlines in a fast-paced environment.</li></ul><p>Job Type: Full-time</p><p>Pay: Rs90,000.00 - Rs120,000.00 per month</p>

RCM SPECIALIST (USA HEALTHCARE)

<p><b>Job Summary:</b><br/>The Medical Billing Associate is responsible for creating and processing accurate medical bills and claim forms (including HCFA/CMS-1500), ensuring compliance with payer requirements and coding standards. The role requires strong knowledge of CPT and ICD-10 codes, attention to detail, and an understanding of healthcare billing workflows to ensure timely and accurate claim submission and reimbursement.<b>Key Responsibilities:</b></p><ul><li>Prepare and generate accurate medical bills and HCFA (CMS-1500) claim forms based on patient encounters and medical documentation.</li><li>Review and validate patient demographics, provider details, insurance information, and service codes before claim creation.</li><li>Apply correct CPT, ICD-10, and HCPCS codes to ensure claims meet payer requirements.</li><li>Verify claim accuracy and completeness prior to submission to clearinghouses or payers.</li><li>Identify and correct billing errors to minimize claim rejections or denials.</li><li>Coordinate with the coding, charge entry, and AR teams to ensure accurate and timely billing.</li><li>Maintain compliance with HIPAA, CMS, and payer-specific billing regulations.</li><li>Assist in claim resubmissions, adjustments, and appeals when necessary.</li><li>Maintain organized billing records and documentation for audit and reporting purposes.</li></ul><p><b>Qualifications and Requirements:</b></p><ul><li>Bachelor&rsquo;s degree in Commerce, Healthcare Administration, or a related field (preferred).</li><li>1&ndash;3 years of experience in U.S. medical billing or revenue cycle operations.</li><li>Proficiency in preparing HCFA/CMS-1500 claim forms and using billing software (e.g., Kareo, AdvancedMD, eClinicalWorks, Athenahealth, or similar).</li><li>Understanding of CPT, ICD-10, and HCPCS coding systems.</li><li>Excellent attention to detail, analytical ability, and organizational skills.</li><li>Good communication and coordination skills for working with cross-functional teams.</li><li>Ability to work independently and meet deadlines in a fast-paced environment.</li></ul><p>Job Type: Full-time</p><p>Pay: Rs80,000.00 - Rs100,000.00 per month</p>

Medical Biller (US EALTHCARE NIGHT SHIFT)

<p><b>ob post summary</b></p><p><b>Date posted:</b> October 21, 2025</p><p><b>Pay:</b> 80,000.00 (PKR) - 110,000.00 (PKR) per month</p><p>Job description:</p><p><b>Job Summary:</b><br/>The Medical Billing Associate is responsible for creating and processing accurate medical bills and claim forms (including HCFA/CMS-1500), ensuring compliance with payer requirements and coding standards. The role requires strong knowledge of CPT and ICD-10 codes, attention to detail, and an understanding of healthcare billing workflows to ensure timely and accurate claim submission and reimbursement.<b>Key Responsibilities:</b></p><ul><li>Prepare and generate accurate medical bills and HCFA (CMS-1500) claim forms based on patient encounters and medical documentation.</li><li>Review and validate patient demographics, provider details, insurance information, and service codes before claim creation.</li><li>Apply correct CPT, ICD-10, and HCPCS codes to ensure claims meet payer requirements.</li><li>Verify claim accuracy and completeness prior to submission to clearinghouses or payers.</li><li>Identify and correct billing errors to minimize claim rejections or denials.</li><li>Coordinate with the coding, charge entry, and AR teams to ensure accurate and timely billing.</li><li>Maintain compliance with HIPAA, CMS, and payer-specific billing regulations.</li><li>Assist in claim resubmissions, adjustments, and appeals when necessary.</li><li>Maintain organized billing records and documentation for audit and reporting purposes.</li></ul><p><b>Qualifications and Requirements:</b></p><ul><li>Bachelor&rsquo;s degree in Commerce, Healthcare Administration, or a related field (preferred).</li><li>1&ndash;3 years of experience in U.S. medical billing or revenue cycle operations.</li><li>Proficiency in preparing HCFA/CMS-1500 claim forms and using billing software (e.g., Kareo, AdvancedMD, eClinicalWorks, Athenahealth, or similar).</li><li>Understanding of CPT, ICD-10, and HCPCS coding systems.</li><li>Excellent attention to detail, analytical ability, and organizational skills.</li><li>Good communication and coordination skills for working with cross-functional teams.</li><li>Ability to work independently and meet deadlines in a fast-paced environment.</li></ul><p>Job Type: Full-time</p><p>Job Type: Full-time</p><p>Pay: Rs80,000.00 - Rs110,000.00 per month</p>

Associate Billing Executive (Night Shift)

Contour Software

<div><div>About Contour</div><div></div><div><div>
Contour Software</div> has grown from a dozen people to over 2,000 staff across 3 cities, in less than 14 years.</div><div><br>
As a subsidiary of Constellation Software Inc., we are proud to be part of a global enterprise software conglomerate that has grown to become one of the top 10 software companies in the world, with employees and customers in 100+ countries. With a broad-based and ever-growing portfolio of market-leading, vertical-market enterprise solutions covering more than 100 industry domains in predominantly mature markets, CSI's recipe creates the perfect environment for professionals to build fulfilling, long-term careers.</div><div><br>
What started as an R&amp;D &amp; Accounting back-office, has progressed into a full-service Global Centre serving all functions and departments, at the divisional as well as operating group/corporate level. Today Contour employees, located in Karachi, Lahore &amp; Islamabad, are serving CSI divisions located in time zones spanning the globe, from Sydney to Vancouver. With the global growth of Constellation as the wind in our sails, we are only just getting started!</div><div></div><div>
The Division:<br>
PYXiS Software Group, a wholly owned portfolio of the Jonas Operating Group of Constellation Software (TSX: CSU), is seeking a highly motivated Billing Specialist to join our growing finance team. The Billing Specialist will be responsible for supporting the invoicing process, ensuring accuracy in billing, and maintaining strong relationships with other stakeholders within PYXiS Software Group. This role plays a critical part in the company&rsquo;s revenue cycle and requires excellent communication skills, time management and a proactive approach to problem-solving.<br>
<br>
Role Overview:<br>
This is an exciting opportunity to launch your career in finance and accounting within a dynamic and growing organization. As a Junior Billing Specialist, you&rsquo;ll play a key role in supporting the billing and revenue operations across a portfolio of software companies. You&rsquo;ll gain hands-on experience in financial processes, collaborate with cross-functional teams, and build a strong foundation in billing and compliance.<br>
<ul><li>Foundational Financial Experience: Support core billing activities, including invoice preparation, account reconciliation, and revenue tracking, while learning best practices in financial operations.</li><li>Cross-Functional Collaboration: Work closely with finance, operations, and collections teams to ensure accurate and timely billing, and assist in resolving client inquiries.</li><li>Month-End Support: Contribute to month-end close processes by preparing billing reports, validating data, and ensuring compliance with internal controls.</li><li>Growth &amp; Learning: Participate in training and mentorship opportunities to build your knowledge of financial systems, billing software, and accounting principles.</li><li>Career Development: Join a growing, collaborative finance team with a pathway for career advancement.</li></ul><br>
Your Core Responsibilities:<br>
Reporting to the Senior Billing Specialist, the core responsibilities of the position are:<br>
<ul><li>Prepare and process invoices, for activities across multiple PYXiS business units, ensuring timely and accurate billing.</li><li>Collaborate effectively with sales and customer service teams to investigate and resolve billing discrepancies and respond to client inquiries.</li><li>Verify the accuracy and completeness of billing data for all services rendered, and maintain financial integrity.</li><li>Support the Collections team with monthly bulk payment processing (e.g., direct debit) and provide backup during team absences or vacations.</li><li>Maintain organized records of customer-related documentation, ensuring proper document management and compliance with internal policies.</li><li>Support audit activities and other ad hoc requests by providing relevant billing and financial information as needed.</li><li>Perform additional duties and responsibilities as assigned to support the broader finance and billing operations</li></ul><br>
Who You Are:<br>
<br>
<ul><li>Minimum of 2 years of experience in billing, accounts receivable, or a finance-related role.</li><li>Demonstrates a proactive and enthusiastic approach to learning, with a positive attitude and strong work ethic.</li><li>Knowledge of fundamental accounting principles.</li><li>Familiarity with billing processes and practical experience using invoicing software; exposure to Salesforce and/or Microsoft Dynamics GP (Great Plains) is considered an asset.</li><li>Proficient in Microsoft Office applications, with intermediate-level skills in Excel, including the use of spreadsheets, pivot tables, and basic formulas.</li><li>Capable of working independently while also contributing effectively within a collaborative team environment.</li><li>Problem-solving skills, with keen attention to detail and effective time management and organizational skills.</li><li>Sound communication and interpersonal skills, with the ability to build and maintain relationships across departments in a dynamic business setting.</li><li>Comfortable adapting to change and managing multiple priorities in a fast-paced environment.</li><li>Willingness and flexibility to work overtime during peak periods or critical deadlines.</li></ul></div><div><br>
Exciting Benefits we offer:</div><ul><li><div>
Market-leading Salary</div></li><li><div>
Medical Coverage &ndash; Self &amp; Dependents</div></li><li><div>
Parents Medical Coverage</div></li><li><div>
Provident Fund</div></li><li><div>
Employee Performance-based bonuses</div></li><li><div>
Home Internet Subsidy</div></li><li><div>
Conveyance Allowance</div></li><li><div>
Profit Sharing Plan [Tenured Employees Only]</div></li><li><div>
Life Benefit</div></li><li><div>
Child Care Facility</div></li><li><div>
Company Provided Lunch/Dinner</div></li><li><div>
Professional Development Budget</div></li><li><div>
Recreational area for in-house games</div></li><li><div>
Sporadic On-shore training opportunities</div></li><li><div>
Friendly work environment</div></li><li><div>
Leave Encashment</div></li></ul><div></div><div><i>
Disclaimer:</i><i> At Contour, we attribute our success to the unique contributions of our diverse staff. We&rsquo;re committed to fostering a culture of respect that thrives on the varied perspectives and experiences of all individuals we recruit, employ, promote, and compensate. Since day one, we&rsquo;ve adhered to a policy that champions a work environment honoring the worth and dignity of each person while being free from all forms of employment discrimination.</i></div><div></div><div><i>
In our continuous effort to promote inclusivity, we extend our commitment to individuals with special needs by providing reasonable accommodations. We actively encourage qualified individuals with special needs to apply for the various openings within our company. Should you require assistance in completing the application process or have any inquiries regarding special facilities, please do not hesitate to contact our HR team. Your unique talents and abilities are welcomed and valued here.</i></div></div><div></div>

Junior Billing Specialist

Explore 2098+ Denial management specialist medical billing us healthcare in Karachi this November. Find roles across top companies and apply now to boost your career.