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medical billing and coding specialist

Eplanet Global

Job Title: AR Specialist &ndash; Medical BillingLocation: Karachi (Onsite) Experience: 2&ndash;5 Years (US Healthcare AR) Shift: US Shift (Night) Salary Range: 150K&ndash; 160K PKR (depending on experience)Job Summary:I am looking for a skilled AR Specialist (Medical Billing) with hands-on experience in US healthcare revenue cycle management. The candidate will be responsible for managing insurance follow-ups, claim resolutions, and ensuring maximum reimbursement by working on denied, rejected, and unpaid claims.Key Responsibilities:<ul><li>Work on Accounts Receivable (AR) for US healthcare clients</li><li>Perform insurance follow-ups on unpaid/underpaid claims (via calls/portals)</li><li>Analyze and resolve denied and rejected claims</li><li>Handle payment posting discrepancies and reconciliation</li><li>Ensure timely appeals filing for denied claims</li><li>Work on aging reports (30/60/90/120+ days) and prioritize collections</li><li>Coordinate with billing and coding teams to fix claim issues</li><li>Maintain accurate documentation of follow-ups and actions taken</li><li>Meet daily/weekly productivity and collection targets</li></ul>Required Skills &amp; Qualifications:<ul><li>Bachelor&rsquo;s degree (preferred)</li><li>2&ndash;5 years of US Medical Billing AR experience</li><li>Strong understanding of RCM (Revenue Cycle Management)</li><li>Knowledge of CPT, ICD-10, HCPCS codes</li><li>Familiarity with insurance portals (e.g., Availity, Navinet)</li><li>Experience with denial management &amp; appeals</li><li>Good communication skills for US insurance calling</li><li>Proficiency in MS Excel and billing software</li></ul>Preferred:<ul><li>Experience in specialties (e.g., Radiology, DME, Internal Medicine, etc.)</li><li>Exposure to EHR/EMR systems (e.g., Kareo, AdvancedMD, eClinicalWorks)</li></ul>KPIs / Performance Metrics:<ul><li>AR aging reduction</li><li>Collection ratio / recovery rate</li><li>Denial resolution turnaround time</li><li>Productivity (claims handled per day)</li><li>Quality &amp; accuracy of follow-ups</li></ul>Job Type: Full-timePay: Rs150,000.00 - Rs160,000.00 per monthWork Location: In person

AR Specialist – Medical Billing

Memom Medial Group Pvt Ltd

Location: main shah faisal road karachi Salary: PKR 75,000 - 150,000 About Us: We are looking for a Medical Order Processor to handle medical order submissions and ensure compliance with US healthcare standards. The ideal candidate will be responsible for processing medical claims, reviewing patient documentation, and liaising with insurance companies. Key Responsibilities:<ul><li>Process medical orders efficiently as per US healthcare regulations.</li><li>Verify medical documentation and ensure accurate claim submission.</li><li>Communicate with healthcare providers, insurance companies, and patients to confirm coverage.</li><li>Ensure compliance with US healthcare billing and coding standards.</li></ul>Required Skills:<ul><li>2-3 years of experience in medical order processing.</li><li>Familiarity with US healthcare systems and insurance policies.</li><li>Strong knowledge of CPT, ICD-10, and HCPCS codes.</li><li>Proficiency in billing software and claim processing tools.</li><li>English verbal &amp; written communication is mandatory.</li></ul>Benefits (Post-Probation): ✅ Medical OPD &amp; hospitalization (family included). ✅ Fuel allowance. ✅ Generous leave policy. ✅ Provident Fund (as per company policy).Job Type: Full-timePay: Rs75,000.00 - Rs150,000.00 per monthWork Location: In person

Medical Order Processor – Urgently Required (US-Health Sector)

Caregenix Solutions

Role: RCM Specialist Location: Cherry Plaza, DHA Phase 2, Karachi Shift: 6:00 PM &ndash; 3:00 AM (US Hours) Compensation: Competitive Salary + Fuel Allowance / TransportRequirements: <ul><li>3&ndash;5 years of proven experience in Medical Billing / Revenue Cycle Management.</li><li>Strong understanding of US healthcare billing processes, insurance claims, and denials management.</li><li>Excellent English communication skills (written &amp; spoken).</li><li>Leadership skills and ability to mentor junior team members.</li><li>Detail-oriented, analytical, and results-driven.</li></ul>What We Offer:<ul><li>A competitive compensation package</li><li>Opportunities for career growth and leadership roles</li><li>A collaborative and supportive work environment</li></ul>Job Type: Full-timePay: Up to Rs150,000.00 per monthApplication Question(s):<ul><li>What is your expected pay?</li></ul>Work Location: In person

RCM Specialist/Medical billing Specialist

Boston Neurobehavioral Associates

<div>
 
 
 
 Citadel Healthcare Management (PVT) LTD.
 
 provides healthcare management services for practices across North America. Our dedicated team supports a wide range of medical administration tasks, working collaboratively across multiple disciplines.
 
 
 
 
 Our mission is to offer employees meaningful opportunities to apply their expertise, grow in their careers, and contribute to the organization&rsquo;s ongoing success.
 
 
 
 
 We are committed to creating a workplace where employees feel valued, supported, and motivated. By fostering a collaborative and engaging environment, we ensure that every contribution is recognized and appreciated.
 
 
 
 
 At Citadel, diversity and inclusion are at the heart of our culture. We welcome individuals from all backgrounds&mdash;regardless of gender, ethnicity, age, religion, lifestyle, or disability&mdash;and embrace the unique perspectives and experiences they bring. Through teamwork, innovation, and continuous professional development, we empower our employees to thrive and drive progress within the organization.
 
 
 
 
 
 As
 
 Quality Assurance Analyst &ndash; RCM &amp; Credentialing
 
 - of CHM you will be liable to perform the following job duties:
 
 
 &nbsp;
 
 
 Essential Duties and Responsibilities:
 
 
 <ul>
 <li>
 
 Perform daily auditing of RCM accounts worked by staff to ensure accuracy based on QA policies and procedures
 
 </li>
 <li>
 
 Review credentialing files for accuracy, completeness, and compliance with state/federal regulations and internal policies
 
 </li>
 <li>
 
 Enter, update, and maintain or audit provider data within credentialing databases and tracking systems
 
 </li>
 <li>
 
 Gather and document general documentation issues for educational feedback purposes
 
 </li>
 <li>
 
 Maintain QA findings and complete monthly summary reports based on daily audit results, and distribute them to management
 
 </li>
 <li>
 
 Communicate quality deficiencies to staff and provide detailed feedback where necessary
 
 </li>
 <li>
 
 Identify and trend recurring errors and report them to management to support training and process improvement
 
 </li>
 <li>
 
 Work closely with department management to review and improve workflows and ensure account resolution efficiency
 
 </li>
 <li>
 
 Assist in the training of new staff related to QA policies and procedures
 
 </li>
 <li>
 
 Report payor issues, system issues, or staff-related issues to management
 
 </li>
 <li>
 
 Respond to inquiries from other departments as needed
 
 </li>
 <li>
 
 Ensure compliance with information systems security policies, attend required training, and report any security concerns
 
 </li>
 <li>
 
 Adhere to the company code of conduct, ethics policies, and compliance requirements,&nbsp;including reporting any violations appropriately
 
 </li>
 <li>
 
 Complete QA summary files and support overall QA reporting processes
 
 </li>
 <li>
 
 Support company values and perform other duties as assigned
 
 </li>
 </ul>
 <ul>
 <li>
 
 
 
 
 Benefits
 
 
 
 
 </li>
 <li>
 <ul>
 <li>
 <ul>
 <li>
 
 
 
 Provident Fund
 
 
 
 </li>
 <li>
 
 
 
 Leave Encashment
 
 
 
 </li>
 <li>
 
 
 
 Gratuity
 
 
 
 </li>
 <li>
 
 
 
 Health Insurance
 
 
 
 </li>
 <li>
 
 
 
 Inflation Bonus
 
 
 
 </li>
 <li>
 
 
 
 Housing Allowance
 
 
 
 </li>
 <li>
 
 
 
 Patient seen Bonus
 
 
 
 </li>
 <li>
 
 
 
 Eid Bonus
 
 
 
 </li>
 </ul>
 </li>
 </ul>
 </li>
 </ul>
 
 Salary:
 
 
 60,000PKR - 80,000PKR
 
 
 &nbsp;
</div>

RCM & Credentialing Quality Assurance Analyst –  USA

Agay Barho!

<div>
 Our client EFU Life Assurance Ltd. is looking for a Claims Assessment Specialist - Medical Insurance in Karachi
 
 
 EFU Life Assurance Ltd. is seeking an Assistant Manager - Claims Doctor with at least two years of experience in medical claims assessment and insurance claims processing. The ideal candidate must hold an MBBS degree and possess comprehensive knowledge of medical terminology, diagnosis and treatment protocols, clinical procedures, and healthcare systems. This position focuses on accurately evaluating and processing insurance and medical claims, ensuring compliance with industry standards, and supporting the claims team with expert assessments. While this role does not involve managing a team, it requires close collaboration with various departments to facilitate effective claims management and resolution.
 
 
 
 Responsibilities
 
 
 
 <ul>
 <li>
 Evaluate medical claims using detailed knowledge of diagnosis, treatment protocols, and clinical procedures to determine validity and coverage eligibility.
 </li>
 <li>
 Process insurance and medical claims efficiently, ensuring all documentation accurately reflects the services provided and complies with healthcare billing and coding standards.
 </li>
 <li>
 Apply ICD-10 coding standards and healthcare billing practices to assess claims and verify the accuracy of claim submissions.
 </li>
 <li>
 Collaborate with claims adjusters, healthcare providers, and internal departments to clarify information, resolve discrepancies, and expedite claims processing.
 </li>
 <li>
 Analyze medical reports and documentation to identify any inconsistencies or fraudulent claims while adhering to company policies and regulatory requirements.
 </li>
 <li>
 Provide expert consultation to underwriters and claims managers on complex medical issues related to claims evaluation.
 </li>
 <li>
 Maintain updated knowledge of healthcare systems, clinical guidelines, and emerging trends to enhance the accuracy and effectiveness of claims assessments.
 </li>
 <li>
 Ensure compliance with company standards, legal requirements, and ethical guidelines throughout the claims processing cycle.
 </li>
 <li>
 Support continuous improvement initiatives by recommending process enhancements for medical claims assessment and insurance claims management.
 </li>
 <li>
 Document findings and prepare detailed reports to support claim decisions and assist in audit or dispute resolution processes.
 </li>
 </ul>
</div>

Claims Assessment Specialist - Medical Insurance - TJ / 1841924

Boston NeuroBehavioral Associates

<div><div>Citadel Healthcare Management (PVT) LTD. provides healthcare management services for practices across North America. Our dedicated team supports a wide range of medical administration tasks, working collaboratively across multiple disciplines.
Our mission is to offer employees meaningful opportunities to apply their expertise, grow in their careers, and contribute to the organization&rsquo;s ongoing success.
We are committed to creating a workplace where employees feel valued, supported, and motivated. By fostering a collaborative and engaging environment, we ensure that every contribution is recognized and appreciated.
At Citadel, diversity and inclusion are at the heart of our culture. We welcome individuals from all backgrounds&mdash;regardless of gender, ethnicity, age, religion, lifestyle, or disability&mdash;and embrace the unique perspectives and experiences they bring. Through teamwork, innovation, and continuous professional development, we empower our employees to thrive and drive progress within the organization. 
As Quality Assurance Analyst &ndash; RCM &amp; Credentialing - of CHM you will be liable to perform the following job duties: 
Essential Duties and Responsibilities:<ul><li>
Perform daily auditing of RCM accounts worked by staff to ensure accuracy based on QA policies and procedures</li><li>
Review credentialing files for accuracy, completeness, and compliance with state/federal regulations and internal policies</li><li>
Enter, update, and maintain or audit provider data within credentialing databases and tracking systems</li><li>
Gather and document general documentation issues for educational feedback purposes</li><li>
Maintain QA findings and complete monthly summary reports based on daily audit results, and distribute them to management</li><li>
Communicate quality deficiencies to staff and provide detailed feedback where necessary</li><li>
Identify and trend recurring errors and report them to management to support training and process improvement</li><li>
Work closely with department management to review and improve workflows and ensure account resolution efficiency</li><li>
Assist in the training of new staff related to QA policies and procedures</li><li>
Report payor issues, system issues, or staff-related issues to management</li><li>
Respond to inquiries from other departments as needed</li><li>
Ensure compliance with information systems security policies, attend required training, and report any security concerns</li><li>
Adhere to the company code of conduct, ethics policies, and compliance requirements, including reporting any violations appropriately</li><li>
Complete QA summary files and support overall QA reporting processes</li><li>
Support company values and perform other duties as assigned</li></ul></div><ul><li><div>
Benefits</div></li><li><div><ul><li><div><ul><li>
Provident Fund</li><li>
Leave Encashment</li><li>
Gratuity</li><li>
Health Insurance</li><li>
Inflation Bonus</li><li>
Housing Allowance</li><li>
Patient seen Bonus</li><li>
Eid Bonus</li></ul></div></li></ul></div></li></ul>
Salary: 
60,000PKR - 80,000PKR
Oj5ntTc4wd</div>

Quality Assurance Analyst – RCM & Credentialing Medical Billing USA

Workflow Hub

Job Summary:Workflow Hub is seeking an experienced and driven Senior Medical Biller. This position supports a multi-specialty medical practice based in Manhattan, United States, with specialties in Primary Care, Cardiology, Neurology, Preventive Care, and Women&rsquo;s Health. The ideal candidate will take charge of end-to-end revenue cycle management, optimize operational performance, and drive excellence in communication across payers, patients, and internal teams.Key Responsibilities:<ul><li>Review patient charts and assign appropriate ICD-10, CPT, and HCPCS codes</li><li>Prepare and submit accurate insurance claims to payers</li><li>Verify patient insurance eligibility and benefits</li><li>Follow up on unpaid or denied claims in a timely manner</li><li>Handle claim corrections, resubmissions and appeals</li><li>Generate and send patient statements</li><li>Maintain compliance with healthcare regulations and billing standards</li></ul>Requirements:<ul><li>1&ndash;3 years of medical billing experience (internal medicine preferred)</li><li>Strong knowledge of ICD-10, CPT, and HCPCS coding systems</li><li>Familiarity with E/M (Evaluation &amp; Management) coding</li><li>Experience with EMR/EHR systems and billing software</li><li>Understanding of insurance guidelines (Medicare, Medicaid, commercial payers)</li><li>Excellent attention to detail and Organizational skills</li><li>Strong communication and problem-solving abilities</li></ul>Preferred Qualifications<ul><li>Prior experience in an internal medicine practice</li><li>Ability to handle high-volume billing tasks</li><li>Knowledge of denial management and revenue cycle processes</li></ul>How to ApplyPlease submit your resume and a brief cover letter to: billing@mmedicalarts.comJob Type: Full-timePay: From Rs100,000.00 per monthExperience:<ul><li>RCM: 5 years (Preferred)</li></ul>Language:<ul><li>English (Required)</li></ul>Work Location: In person

Senior Medical Biller / Internal Medicine

Explore 2747+ Medical billing and coding specialist in Karachi this April. Find roles across top companies and apply now to boost your career.