authorization specialist in medical billing

business development & sales support specialist

business development manager (bdm) – billing field

customer service representative (csr) – medicare & aca

experienced usa / uk syllabus teacher (english / bio / chemistry)

authorization specialist in medical billing Jobs in Rawalpindi

business development & sales support specialist Jobs in Rawalpindi

business development manager (bdm) – billing field Jobs in Rawalpindi

customer service representative (csr) – medicare & aca Jobs in Rawalpindi

data entry specialist

medical billing and coding specialist

Bbm solutions

Responsibilities:<ul><li>Submit and follow up on medical claims to ensure timely payment.</li><li>Resolve billing discrepancies and insurance denials.</li><li>Manage accounts receivable and monitor AR aging.</li><li>Maintain accurate billing records and generate reports.</li></ul>Requirements:<ul><li>Proven experience in medical billing and AR.</li><li>Knowledge of medical coding, insurance, and billing software.</li><li>Detail-oriented with strong communication skills.</li></ul>Job Type: Full-timePay: Rs70,000.00 - Rs100,000.00 per monthWork Location: In person

Senior Medical Billing Executive/ AR Specialist

PMTAC Pvt Ltd

Job Title: SNF Medicare Billing Specialist &ndash; PDPM (Skilled Nursing Facility)Location: Rawalpindi, Pakistan (Onsite) Company: PMTAC Pvt. Ltd. Shift: Night Shift (US Healthcare)Position OverviewPMTAC is seeking an experienced SNF Medicare Billing Specialist with strong knowledge of the Patient-Driven Payment Model (PDPM) and Skilled Nursing Facility (SNF) Medicare Part A billing requirements. The ideal candidate will have hands-on experience with MDS-driven reimbursement, HIPPS coding, and UB-04 claim submission.This role requires a strong understanding of Centers for Medicare &amp; Medicaid Services (CMS) billing guidelines and compliance regulations.Key Responsibilities1. Medicare Eligibility Verification<ul><li>Verify Medicare Part A coverage for SNF residents.</li><li>Confirm qualifying 3-day hospital stay and benefit period.</li><li>Review secondary insurance coverage (Medicaid, Medicare Advantage, commercial payers).</li></ul>2. MDS &amp; PDPM Coordination<ul><li>Review and ensure accurate completion of Minimum Data Set (MDS) assessments.</li><li>Validate:</li><li>Clinical conditions</li><li>Functional status</li><li>Comorbidities</li><li>Confirm HIPPS code generation from MDS.</li><li>Ensure documentation supports PDPM classification.</li><li>Understand and apply the guidelines of the Patient-Driven Payment Model.</li></ul>3. UB-04 (CMS-1450) Claim Preparation<ul><li>Prepare and submit facility claims using the UB-04 (CMS-1450) form.</li><li>Accurately complete required fields including:</li><li>Type of Bill (21X)</li><li>Statement Covers Period</li><li>Revenue Codes (0022&ndash;0029 for PDPM)</li><li>HIPPS Code</li><li>Units (covered days)</li><li>Total Charges</li><li>Occurrence Codes (qualifying hospital stay)</li><li>Ensure proper reporting of PDPM per diem billing structure.</li></ul>4. Claim Submission &amp; Follow-Up<ul><li>Submit claims electronically via EDI/clearinghouse or CMS DDE.</li><li>Work with Medicare Administrative Contractors (MACs).</li><li>Monitor claim status and resolve denials or RTPs.</li><li>Submit corrected claims when MDS or HIPPS codes change.</li></ul>5. Payment Reconciliation &amp; Post-Processing<ul><li>Post Medicare payments and reconcile PDPM variable per diem rates.</li><li>Identify underpayments or discrepancies.</li><li>Coordinate professional claims (CMS-1500) separately from facility billing.</li></ul>6. Compliance &amp; Audit Readiness<ul><li>Ensure clinical documentation supports billed services.</li><li>Maintain compliance with CMS and Medicare billing regulations.</li><li>Assist with audits and ADR responses.</li></ul>Required Qualifications<ul><li>Minimum 2&ndash;3 years of SNF Medicare Part A billing experience.</li><li>Strong knowledge of PDPM reimbursement methodology.</li><li>Experience working with MDS assessments and HIPPS coding.</li><li>Proficiency in UB-04 (CMS-1450) claim preparation.</li><li>Understanding of revenue codes 0022&ndash;0029.</li><li>Familiarity with Medicare Administrative Contractors (MACs).</li><li>Experience with electronic billing systems and clearinghouses.</li><li>Strong attention to detail and regulatory compliance knowledge.</li></ul>Preferred Qualifications<ul><li>RHIT, RHIA, CPC, or CPB certification.</li><li>Experience in long-term care or post-acute care settings.</li><li>Knowledge of Medicare Advantage SNF billing.</li></ul>Core Competencies<ul><li>Knowledge of PDPM case-mix components (PT, OT, SLP, Nursing, NTA).</li><li>Understanding of variable per diem adjustments.</li><li>Ability to analyze MDS-driven reimbursement.</li><li>Strong denial management skills.</li><li>Excellent documentation review and audit readiness skills.</li></ul>Interested candidates with SNF Medicare Billing Specialist are encouraged to apply by sharing their CV at: careers@pmtac.coma.arslan@pmtac.com Subject: SNF Medicare Billing SpecialistJob Type: Full-timePay: Rs80,000.00 - Rs150,000.00 per monthExperience:<ul><li>SNF Medicare PDPM billing: 2 years (Required)</li><li>MDS assessments and HIPPS coding: 2 years (Required)</li><li>UB-04 (CMS-1450) claim preparation: 2 years (Required)</li></ul>License/Certification:<ul><li>RHIT, RHIA, CPC, or CPB certification (Required)</li></ul>Location:<ul><li>Rawalpindi (Required)</li></ul>Work Location: In person

SNF Medicare Billing Specialist – PDPM (Skilled Nursing Facility)

The Inventor Solutions

Location: On-Site &ndash; Rawalpindi Shift: Night Shift (7PM to 4AM) Employment Type: Full-TimeAbout The Inventor SolutionsThe Inventor Solutions is a US-focused healthcare RCM and digital solutions company providing medical and dental billing services to clinics across the United States. We are expanding our medical billing division and seeking an experienced Pulmonology Billing Specialist to join our growing operations team.Key Responsibilities<ul><li>End-to-end medical billing for Pulmonology practices (US market)</li><li>Charge entry &amp; claim submission (CMS-1500)</li><li>Insurance verification &amp; eligibility checks</li><li>AR follow-up on commercial, Medicare &amp; Medicaid claims</li><li>Denial management &amp; appeals</li><li>Posting ERA/EOB payments</li><li>Handling PFTs, Sleep Studies (CPT 94010, 94660, 95800&ndash;95811 etc.)</li><li>DME &amp; CPAP-related billing knowledge preferred</li><li>Coordination with front desk &amp; providers for documentation gaps</li></ul>Required Experience<ul><li>2+ years US medical billing experience</li><li>Minimum 1 year in Pulmonology billing (mandatory)</li><li>Strong understanding of ICD-10, CPT, HCPCS</li><li>Experience with Medicare guidelines</li><li>Knowledge of modifier usage (26, TC, 25, 59 etc.)</li><li>Familiar with EMR/EHR systems</li></ul>Preferred Qualifications<ul><li>Experience with Sleep Medicine billing</li><li>Familiarity with DME claims</li><li>Experience handling high AR aging accounts</li><li>Ability to work independently under KPIs</li></ul>What We Offer<ul><li>Competitive market salary</li><li>Performance-based growth structure</li><li>Career progression within US RCM operations</li><li>Professional, growth-oriented work environment</li></ul>Job Type: Full-timeExperience:<ul><li>Medical Billing: 1 year (Required)</li><li>Pulmonology: 1 year (Required)</li></ul>Work Location: In person

Medical Billing Associate - Pulmonology

Speak Viral

The Authorization Expert is responsible for obtaining, verifying, and managing prior authorizations for medical services to ensure timely reimbursement and compliance with payer requirements. This role works closely with providers, billing teams, insurance companies, and patients to prevent claim denials and delays related to authorization issues.Key Responsibilities<ul><li>Obtain prior authorizations, referrals, and pre-certifications from insurance payers for medical procedures, treatments, and diagnostic services</li><li>Verify patient insurance eligibility, benefits, coverage limits, and authorization requirements</li><li>Review physician orders and clinical documentation to ensure accuracy and compliance with payer guidelines</li><li>Communicate with insurance companies to follow up on authorization status, appeals, and approvals</li><li>Document authorization details accurately in billing and practice management systems</li><li>Identify and resolve authorization-related denials and underpayments</li><li>Collaborate with providers and billing teams to ensure services are rendered within authorization guidelines</li><li>Stay current with payer policies, authorization rules, and regulatory changes</li><li>Maintain compliance with HIPAA and organizational policies</li><li>Meet productivity, accuracy, and turnaround time standards</li></ul>Required Qualifications<ul><li>2+ years of experience in medical billing, insurance verification, or prior authorizations</li><li>Strong knowledge of insurance plans (commercial, Medicare, Medicaid, managed care)</li><li>Familiarity with CPT, ICD-10, and HCPCS codes</li><li>Experience working with EMR/EHR and medical billing software</li><li>Strong attention to detail and organizational skills</li><li>Excellent verbal and written communication skills</li></ul>Preferred Qualifications<ul><li>Experience in specialty practices (e.g., radiology, surgery, cardiology, orthopedics)</li><li>Certification such as CPC, CPB, or equivalent</li><li>Knowledge of denial management and appeals processes</li></ul>Skills &amp; Competencies<ul><li>Analytical and problem-solving abilities</li><li>Ability to multitask in a fast-paced environment</li><li>Strong follow-up and time-management skills</li><li>Team-oriented with the ability to work independently</li><li>Professional and patient-focused communication style</li></ul>Job Type: Full-timePay: Rs50,000.00 - Rs80,000.00 per monthApplication Question(s):<ul><li>Will you be able to work in night shift(7pm to 4am)?</li><li>Will you be able to commute to Bahria Town Phase 7 Rawalpindi?</li></ul>Work Location: In person

Authorization Specialist in Medical Billing

BLS Solutions

The Eligibility Verification Executive is responsible for making outbound fresh follow-up calls to insurance companies and patients to verify coverage, benefits, and claim status for medical billing. The role ensures accurate and timely confirmation of eligibility to support clean claim submission and reduce denials.Key Responsibilities:Make outbound fresh calls to insurance payers to verify patient eligibility and benefits.Confirm:<ul><li>Active coverage</li><li>Policy effective dates</li><li>Co-pay, co-insurance, and deductible</li><li>Plan limitations and exclusions</li><li>Referral and authorization requirements</li><li>Check claim status for submitted medical bills.</li><li>Update eligibility and verification of details in the billing system.</li><li>Document call reference numbers and payer responses accurately.</li></ul>Identify and report:<ul><li>Inactive policies</li><li>Incorrect member information</li><li>Coverage terminations</li><li>Coordinate with the medical billing and AR team for claim corrections.</li><li>Maintain daily productivity and quality targets.</li><li>Follow HIPAA and data confidentiality guidelines.</li><li>Required Skills</li><li>Good communication and listening skills</li><li>Basic knowledge of medical billing and insurance terminology</li><li>Ability to handle payer portals and call workflows</li><li>Strong attention to detail</li><li>Time management and target-oriented work approach</li><li>Basic computer skills (EHR/Practice Management System, MS Excel)</li><li>Preferred Qualifications</li><li>Bachelor&rsquo;s degree (or equivalent)</li></ul>Fresh:<ul><li>Medical billing</li><li>Eligibility verification</li><li>AR follow-up</li><li>Knowledge of CPT, ICD-10, and HCPCS codes (preferred but not mandatory for fresh candidates)</li><li>Key Performance Indicators (KPIs)</li><li>Number of calls completed per day</li><li>Accuracy of eligibility verification</li><li>Documentation quality</li><li>Reduction in eligibility-related claim denials</li></ul>Job Type: Full-timePay: From Rs50,000.00 per monthWork Location: In person

Medical Billing Follow-up Executive / Eligibility Verification Intern

MaxRemind

Job Title: Business Development &amp; Sales Support SpecialistKey ResponsibilitiesBusiness Development:<ul><li>Deliver Billing Software, EHR, and RCM demos to prospective clients</li><li>Manage proposals, pricing, and contract signing</li><li>Guide clients through onboarding, account setup &amp; activation</li><li>Coordinate with EHR &amp; Billing teams for timely go-live</li><li>Provide first-level support during onboarding</li><li>Maintain professional client communication</li><li>Ensure smooth handoff to long-term support teams</li></ul>Sales Support:<ul><li>Manage inbound leads and qualify prospects</li><li>Schedule demos and support sales conversions</li><li>Generate leads through calls, email, and LinkedIn</li><li>Build and maintain a scalable lead pipeline</li><li>Update CRM with accurate records and follow-ups</li><li>Coordinate with marketing for better lead quality</li></ul>Requirements<ul><li>Strong knowledge of EHR/Billing software</li><li>Excellent communication and interpersonal skills</li><li>2+ years in a similar role or US healthcare industry experience</li><li>Bachelor&rsquo;s degree required (master&rsquo;s preferred)</li></ul>What We Offer<ul><li>Competitive salary package</li><li>Dinner and tea provided</li><li>Career growth and professional development opportunities</li><li>Supportive and collaborative work environment</li></ul>Location: Rawalpindi (On-site) Timings: 5 PM &ndash; 2 AM (Evening Shift)Job Type: Full-timePay: Rs80,000.00 - Rs200,000.00 per monthWork Location: In person

Business Development & Sales Support Specialist

The Medical Billing Executive is responsible for managing the end-to-end medical billing process to ensure accurate and timely submission of claims to insurance companies, patients, and other payers. This role involves reviewing patient data, ensuring compliance with billing regulations, resolving claim denials, and maintaining accurate financial records to optimize revenue cycle performance.Key Responsibilities:<ul><li>Preparing and submitting billing data and medical claims to insurance companies.</li><li>Ensuring the patient&rsquo;s medical information is accurate and up to date.</li><li>Preparing bills and invoices, and documenting amounts due for medical procedures and services.</li><li>Collecting and reviewing referrals and pre-authorizations.</li><li>Monitoring and recording late payments.</li><li>Following up on missed payments and resolving financial discrepancies.</li><li>Examining patient bills for accuracy and requesting any missing information.</li><li>Investigating and appealing denied claims.</li><li>Helping patients develop patient payment plans.</li><li>Maintaining billing software by updating rate change, cash spreadsheets, and current collection reports.</li></ul>Qualifications &amp; Skills:<ul><li>Bachelor&rsquo;s degree in business, health care administration, accounting, or a relevant field.</li><li>A minimum of 2 years of experience as a medical biller or similar role.</li><li>Solid understanding of billing software and electronic medical records.</li><li>Must have the ability to multitask and manage time effectively.</li><li>Excellent written and verbal communication skills.</li><li>Outstanding problem-solving and organizational abilities.</li></ul>Job Type: Full-timePay: Rs45,000.00 - Rs75,000.00 per monthApplication Question(s):<ul><li>Will you be able to work in night shift(7pm to 4am)?</li><li>Will you be able to commute to Bahria Town Phase 7 Rawalpindi?</li></ul>Work Location: In person

Medical Billing Executive

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