medical claims processor

ATLANTIS HOSPITAL

<ul><li><b>Claims Processing:</b> Submitting pre-authorization requests for cashless treatments and processing final, accurate insurance claims.</li><li><b>Liaison/Communication:</b> Acting as a bridge between doctors, hospitals, and TPA partners to ensure timely approvals and payments.</li><li><b>Documentation:</b> Reviewing medical records and insurance documents to prevent claim rejections.</li><li><b>Patient Support:</b> Guiding patients on insurance policy coverage, limitations, and exclusions.</li><li><b>Follow-ups:</b> Monitoring the status of claims and following up daily with insurers to ensure timely settlement.</li><li><b>Data Entry/Management:</b> Maintaining accurate records in TPA portals.</li></ul><p>Job Type: Full-time</p><p>Pay: ₹8,086.00 - ₹20,763.92 per month</p><p>Benefits:</p><ul><li>Health insurance</li><li>Provident Fund</li></ul><p>Work Location: In person</p>

TPA ASSISTANT

Speak Viral

<p>The <b>Medical Billing Executive</b> 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.</p><p><b>Key Responsibilities:</b></p><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><p><b>Qualifications &amp; Skills:</b></p><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><p>Job Type: Full-time</p><p>Pay: Rs45,000.00 - Rs75,000.00 per month</p><p>Application Question(s):</p><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><p>Work Location: In person</p>

Medical Billing Executive

Quadax, Inc.

<div><div><div><div><p><b>Purpose: </b>The XIT Account Representative is responsible for managing the application, customization, and training aspects of an Xpeditor (Claims Management) implementation. In addition to the Quadax proprietary claims processing software (Xpeditor), the XIT Account Representative is responsible for implementing the related software products: Eligibility, Denial Management Workflow, Decision Intelligence, ICV Medicare and Medicaid, Axis, Host Interface Module for Epic, and DDE Link.</p></div></div><p></p><div><div><br>
<p><b>
Job Description:</b></p>
<p>
The XIT Account Representative will work with the managers and billers of a hospital billing department to identify differences with how the Quadax proprietary medical claims processing software (i.e. Xpeditor) edits claims versus the hospital's current EDI system. This process, referred to as &quot;parallel testing&quot;, allows XIT to identify additional customization that may be required in order to bring a new client up into a &quot;production&quot; or &quot;live&quot; status.</p>
<p><b>
Responsibilities:</b></p>
<ul>
<li>Write, test, and document custom data converts and edits.</li>
<li>Work with EDI Client Setup, the EDI Edits and Documentation department, and EDI Transmissions to setup new payers in new territories.</li>
<li>Responsible for providing training to clients which can range from small-to-large sized groups.</li>
<li>Must be detail oriented, able to multitask and maintain professional relationships with multiple clients, and have sufficient public speaking abilities.</li>
<li>Proven track record of learning proprietary software and systems quickly, and in-depth enough to train new clients on their use.</li>
<li>Travel onsite to the client multiple times to complete an implementation. (75% travel)</li></ul></div></div><div><br>
<div>
<p></p><p><b>Application Experience Required:</b></p>
<ul><li>ServiceNow</li></ul>
<ul><li>SharePoint</li></ul>
<ul><li>Microsoft Teams</li></ul>
<ul><li>WorkPlace and Concur</li></ul>
<ul><li>ANSI 5010 837P/837I/835</li></ul>
<ul><li>Programming experience</li></ul></div></div></div></div><p></p>

Account Implementation Representative - Healthcare EDI Software

Accenture in India

<div>
 <strong>
  Skill required:
 </strong>
 Claims Appeals - Claims Administration
 <br/>
 <br/>
 <strong>
  Designation:
 </strong>
 Health Admin Services Associate
 <br/>
 <br/>
 <strong>
  Qualifications:
 </strong>
 Any Graduation
 <br/>
 <br/>
 <strong>
  Years of Experience:
 </strong>
 1-3 Yrs
 <br/>
 <br/>
 <strong>
  About Accenture
  <br/>
  <br/>
 </strong>
 Accenture is a global professional services company with leading capabilities in digital, cloud and security.Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song&mdash; all powered by the world&rsquo;s largest network of Advanced Technology and Intelligent Operations centers. Our 784,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. We embrace the power of change to create value and shared success for our clients, people, shareholders, partners and communities.Visit us at www.accenture.com
 <br/>
 <br/>
 <strong>
  What would you do?
 </strong>
 Embedding digital transformation in healthcare operations end-to-end, driving superior outcomes and value realization today, and enabling streamlined operations to serve the emerging health care market of tomorrowClaims Appeals involves reviewing and processing appeals for denied insurance claims. This includes evaluating the reasons for denial, gathering additional information, and making decisions on the appeal. The goal is to ensure fair and accurate resolution of claims. Responsibilities include communicating with claimants, analyzing documentation, and adhering to regulatory guidelines. This role is essential for maintaining trust and satisfaction in the claims process.Includes the administration of health, life, and property &amp; causality claims. Includes activities involved in core claim processing such as registering claims, editing &amp; verification, claims evaluation, and examination &amp; litigation.
 <br/>
 <br/>
 <strong>
  What are we looking for?
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Conduct pre-service and retrospective Provider and Member Appeals for outpatient and inpatient requests. Reviews service requests to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts.
  </li>
  <li>
   Utilize client specific criteria sets (e.g., Milliman or InterQual), applicable client specific medical policy and client clinical guidelines for decision making to either approve, request for additional clinical information or summarize and route to Client s nursing reviewer and/or Client s medical staff for review.
  </li>
  <li>
   Accurately routes cases to client medical staff for further review when a service or admission does not meet medical necessity, place of service, or benefit criteria.
  </li>
  <li>
   Responsible for conducting medical management review activities which require the review of clinical information against client specific criteria as noted above but excludes denial determinations.
  </li>
  <li>
   Ensure member access to medically necessary, quality healthcare in a cost-effective setting according to contract. Consult with clinical reviewers and/or U.S.-licensed medical directors to ensure medically appropriate, high-quality, cost-effective care throughout the medical management process.
  </li>
  <li>
   Graduate of any college degree or High School Diploma with 6 months&rsquo; BPO work experience.
  </li>
  <li>
   Excellent written and verbal communication skills in English.
  </li>
  <li>
   Must pass American English and alternate language fluency test (&ldquo;Test&rdquo;) upon hire (non-US resident). For voice accounts, must pass US Berlitz B2 level or Versant score of 58 or any language proficiency equivalence.
  </li>
  <li>
   Proficiency in basic computer knowledge with the ability to learn additional computer programs
  </li>
  <li>
   Holds current and unrestricted local Registered Nurse license.
  </li>
  <li>
   Bachelor of Science Nursing (BSN) degree or General Nursing &amp; Midwifery (GNM) Diploma or Basic Bachelor of Science (BSC) in Nursing degree or Associate Nursing Degree or Nursing Diploma
  </li>
  <li>
   A minimum of three (3) months of prior working experience as a Registered Nurse in a clinical setting required.
  </li>
  <li>
   Three months is equivalent to 480 hours of working experience as an RN.
  </li>
  <li>
   Work experience as a Registered Nurse means holding an active RN license and providing direct patient care. Roles and Responsibilities:
  </li>
  <li>
   In this role you are required to solve routine problems, largely through precedent and referral to general guidelines
  </li>
  <li>
   Your primary interaction is within your own team and your direct supervisor
  </li>
  <li>
   In this role you will be given detailed instructions on all tasks
  </li>
  <li>
   The decisions that you make impact your own work and are closely supervised
  </li>
  <li>
   You will be an individual contributor as a part of a team with a predetermined, narrow scope of work
  </li>
  <li>
   Please note that this role may require you to work in rotational shifts, Any Graduation
   <br/>
  </li>
 </ul>
</div>


Health Admin Services Associate

OverIT

<p><b>Job Title:</b> Medical Billing Executive</p><p><b>Job Summary</b><br/>We are seeking a diligent and detail-oriented Medical Billing Executive to oversee and manage the full medical billing cycle. The successful candidate will ensure accurate claim submission, timely reimbursement, and prompt resolution of billing discrepancies. This role is pivotal in maintaining smooth revenue cycle operations by coordinating with healthcare providers, insurance companies, and patients.</p><p><b>Primary Responsibilities</b></p><ul><li>Prepare, review, and submit medical claims in compliance with insurance and regulatory requirements.</li><li>Verify patient insurance coverage, eligibility, and authorizations prior to billing.</li><li>Apply accurate CPT, ICD, and HCPCS coding to all claims to ensure correct billing.</li><li>Monitor status of submitted claims; follow up on unpaid or rejected claims and take corrective action as needed.</li><li>Post payments and adjustments; maintain accurate and up-to-date patient account records.</li><li>Address patient billing inquiries and provide clear, professional explanations of charges.</li><li>Coordinate with healthcare providers and internal departments to resolve billing or coding issues.</li><li>Generate regular billing, reimbursement, and collections reports (daily/weekly/monthly).</li><li>Manage accounts receivable &mdash; ensuring outstanding balances are tracked and collected timely.</li><li>Ensure compliance with HIPAA and all applicable healthcare billing regulations.</li></ul><p><b>Required Qualifications and Competencies</b></p><ul><li>Bachelor&rsquo;s degree, or relevant certification in Medical Billing, Healthcare Administration, or a related field.</li><li>1&ndash;3 years (or more) of experience in medical billing or revenue-cycle management within a healthcare setting.</li><li>Strong knowledge of medical terminology, coding standards (CPT, ICD, HCPCS), and insurance claim procedures.</li><li>Proficiency in medical billing software and electronic health record (EHR) systems.</li><li>Excellent analytical skills, attention to detail, and ability to maintain accuracy under pressure.</li><li>Strong communication skills &mdash; both written and verbal &mdash; with ability to interact professionally with patients, providers, and insurers.</li><li>Capability to work independently and collaboratively as part of a team, prioritizing tasks effectively and managing deadlines.</li></ul><p><b>Desirable Attributes</b></p><ul><li>Demonstrated ability to manage multiple billing tasks concurrently while maintaining high accuracy and compliance standards.</li><li>Commitment to maintaining patient confidentiality and adherence to statutory and regulatory guidelines.</li><li>Capacity to adapt to evolving healthcare billing practices and regulatory changes.</li></ul><p><b>Job Details</b></p><ul><li>5 days working (Sat-Sun Off)</li><li>Night shift (8:00AM to 5:00PM)</li><li>Good communication skills required</li></ul><p>Interest candidates can share their resumes on hr.jal@overit.in</p><p>Job Types: Full-time, Permanent, Fresher</p><p>Pay: ₹15,000.00 - ₹17,000.00 per month</p><p>Benefits:</p><ul><li>Leave encashment</li></ul><p>Work Location: In person</p>

TeamHealth

<div><div><div>TeamHealth is named among the Top 150 Places to Work in Healthcare by Becker's Hospital Review. Newsweek Magazine recognizes TeamHealth as &lsquo;one of the greatest workplaces for diversity, 2024&rsquo;<b> </b>and TeamHealth is also ranked as &lsquo;The World&rsquo;s Most Admired Companies&rsquo; by Fortune Magazine. TeamHealth, an established healthcare organization is physician-led and patient focused. We continue to grow across the U.S. from our Clinicians to Corporate Employees. Join us.<br>
<br>
<b>What we Offer:</b><br>
Career Growth Opportunities<br>
Benefit Eligibility (Medical/Dental/Vision/Life) the first of the month following 30 days of employment<br>
401K (Discretionary matching funds available)<br>
Generous PTO<br>
8 Paid Holidays<br>
Equipment Provided for Remote Roles<br>
<br>
JOB DESCRIPTION OVERVIEW: This position is responsible for reviewing various carrier denials at their assigned Billing Group and submitting appeals accordingly. Maintains accuracy and production to ensure invoices are being processed efficiently.<br>
<br>
ESSENTIAL DUTIES AND RESPONSIBILITIES:<br>
 Reviews ETM task list assignment, comments, and rebills/appeals claim as necessary<br>
 Reviews denials to determine appropriate action based on carrier requirements<br>
 Posts appropriate rejection codes into system where applicable<br>
 Obtains status by establishing carrier contact if the submitted appeal has yielded no response<br>
 Identifies and forwards documentation to appeal disputed claims<br>
 Assembles and forwards appropriate documentation to the senior representative for provider and carrier related issues<br>
 Reviews carrier provider manuals for billing updates as needed<br>
 Reports any consistent errors found during review that affect claims from being processed correctly<br>
 Participates in department meetings with Accounts Receivable Team<br>
 Identifies trends in claims filed outside carrier timely filing deadlines and offers suggestions to prevent future occurrences<br>
 Turns to Senior/Supervisor for unusual circumstances that may include write-offs, fee schedules, claims, etc.<br>
 Performs any and all duties as directed by Senior Representative, Supervisor, and Accounts Receivable Manager
<p><b>
Job Requirements:</b></p>
<p>
EXPERIENCE / SKILLS:
 <br>
One-year medical billing experience
 <br>
Knowledge of physician billing policies and procedures
 <br>
Computer literate
 <br>
Ability to work in a fast-paced environment
 <br>
Excellent organizational skills
 <br>
Ability to work independently<br>
<br>
<br>
<br>
EDUCATION:
 <br>
High school diploma or equivalent.<br>
<br>
WORKING CONDITIONS:
 <br>
This job will be performed in a well-lighted and well-vented environment.<br>
Requires
<br>
constant sitting tolerance.<br>
Involves extensive computer use.<br>
<br>
 Set in a pleasant, high-volume, fast-paced office environment.<br>
<br>
 Overtime may be required and can be mandated by Management.<br>
<br>
DISCLAIMER:<br>
Cooperative, positive, courteous and professional behavior and conduct is an essential function
<br>
of every position.<br>
All employees must be able to work with others beyond giving and receiving
<br>
instructions.<br>
This includes getting along with co-workers, peers and management without
<br>
exhibiting behavior extremes.<br>
Job functions may require personal leadership skills such as
<br>
conflict resolution, negotiating, instructing, persuading, speaking with others as well as
<br>
responding appropriately to job performance feedback from the Manager.<br>
Additionally, the
<br>
information contained in this job description has been designated to indicate the general nature
<br>
and level of work performed by employees within this classification.<br>
It is not designed to contain
<br>
or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications
<br>
required of employees assigned to this position.</p>
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</div><div></div><div><div>Job Snapshot</div>
<div><h4 class="jobSectionHeader"><b>Employee Type</b></h4>
Full-Time
</div><div><h4 class="jobSectionHeader"><b>Location</b></h4>
Louisville, TN (Onsite)
</div><div><h4 class="jobSectionHeader"><b>Job Type</b></h4>
Admin - Clerical
</div><div><h4 class="jobSectionHeader"><b>Experience</b></h4>
Not Specified
</div><div><h4 class="jobSectionHeader"><b>Date Posted</b></h4>
02/25/2026
</div></div></div></div><div><div><div><div><h3 class="jobSectionHeader"><b>Apply to this job.</b></h3>
Think you're the perfect candidate?</div></div></div></div></div><p></p>

Appeals Representative

<div><div><div><b>TeamHealth</b> is proud to be the leading physician practice in the U.S. providing exceptional patient care, together. <b>TeamHealth has been recognized by Newsweek as one of America&rsquo;s Greatest Workplaces in Health Care for 2025</b>. Becker&rsquo;s Hospital Review names TeamHealth among the top 150 places to work in healthcare. We continue to grow across the U.S. from our Clinicians to Corporate Employees. Join us!<br>
<br>
<b>What we Offer:</b><ul>
<li>Career Growth Opportunities</li>
<li>A Culture anchored in a strong sense of belonging</li>
<li>Benefits (Medical/Dental/Vision) begin the first of the month following 30 days of employment</li>
<li>401k (Discretionary match)</li>
<li>Generous PTO</li>
<li>8 Paid Holidays</li>
<li>Equipment Provided for Remote Roles</li>
</ul><br>
<b>OVERVIEW:</b><br>
The Eligibility Representative is responsible for working denial reports and correcting or refiling claims based on denial or rejection and eligibility responses. This person will note each patient&rsquo;s account clearly so that all who need to review accounts will understand the documentation. The Eligibility Representative will also identify FSC according to eligibility website responses and will work from various source documents. This work is routine and repetitive.<br>
<br>
<b>ESSENTIAL DUTIES AND RESPONSIBILITIES:</b><ul>
<li>Identifies appropriate FSC and insurance company</li>
<li>Analyzes rejections and denials, identifies probable cause, and makes necessary corrections to refile claims</li>
<li>Accurately note all patient accounts so that this information can be viewed and understood in the future</li>
<li>Notifies the Sr. Representative and/or Supervisor of system malfunctions and problems arising from erroneous items, codes, or missing information</li>
<li>Performs any and all duties as directed by management</li>
</ul><br>
<b>QUALIFICATIONS / EXPERIENCE:</b><ul>
<li>High School diploma or equivalent required</li>
<li>6 months or more of registration and/or eligibility experience</li>
</ul></div><div><div>Get job alerts by email. <b>Sign up now!</b><b>
</b><p></p>
</div><div></div><div><div>Job Snapshot</div>
<div><h4 class="jobSectionHeader"><b>Employee Type</b></h4>
Full-Time
</div><div><h4 class="jobSectionHeader"><b>Location</b></h4>
Louisville, TN (Hybrid)
</div><div><h4 class="jobSectionHeader"><b>Job Type</b></h4>
Admin - Clerical
</div><div><h4 class="jobSectionHeader"><b>Experience</b></h4>
Not Specified
</div><div><h4 class="jobSectionHeader"><b>Date Posted</b></h4>
03/01/2026
</div></div></div></div><div><div><div><div><h3 class="jobSectionHeader"><b>Apply to this job.</b></h3>
Think you're the perfect candidate?</div></div></div></div></div><p></p>

Eligibility Representative

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TPA ASSISTANT

Medical Billing Executive

Account Implementation Representative - Healthcare EDI Software

Health Admin Services Associate

Medical Billing Executive

Appeals Representative

Eligibility Representative