ModuleMD is a leading SaaS for medical practices in the US. Our solutions include an all-in-one Practice management, Electronic Health Records, and Revenue Cycle Management software together with a Managed Billing Service. We are looking for an experienced Billing Specialist / Senior Billing Specialist to join our team in India.

Company      : ModuleMD Healthcare Solutions Pvt Ltd (website: https://www.modulemd.com)

Job Title       : Billing Specialist / Senior Billing Specialist

Location        : Hyderabad (Currently work from home)

Experience    :  5 years to 10 years

Shift             : US hours – Night shift (5:30 Pm TO 2:30 Am IST)

Joining          : As early as possible

Role              : Permanent position

Education      : Bachelors’ Degree in related field or equivalent experience.

Experience:

• Candidates must have 5+ Years of experience in accounts receivable follow-up / denial management especially a work experience on [claims Denials / Rejections] for US healthcare customers – MUST.
• Working experience on websites like CHAMPS, Medicaid, Medicare etc.
• Work Experience on Aging Analysis Report, Code Sets, Medicaid eligibility etc.
• Should and must have work experience to know the purpose of the ABN, COB, and How to complete a Medicare reconsideration/appeal, the birthday rule, using CHAMPS website etc.
• Experience in denials management and A/R fundamentals, Rejections and Appeals -MUST
• Understanding of ICD-10 and CPT codes -MUST
• Familiarity with multiple insurance web sites for eligibility, claims status, payments, disputes -MUST.
• A very good practical working knowledge to know what information is to be included when an appeal is made for a claim.
• HIPAA rules and regulations – privacy laws, access, and release of information
• Ability to read and understand EOBs/Payment Vouchers -MUST
• Experience in Allergy and Oncology preferred!
• Excellent oral and writing communication abilities as well as call center expertise.
• Ability to work independently, as well as a collaborative team player, in a remote setting.
• Attention to detail.
• Agile mindset: versatility, flexibility, and a willingness to enthusiastically work within constantly shifting priorities.

Responsibilities:

• Maintain adequate documentation on the client software to send necessary documentation to insurance companies and maintain a clear audit trail for future reference.
• Directly communicate with practices
• Post payments as required.
• Denials management A/R follow-ups: Perform analysis of accounts receivable data and understand the reasons for underpayment days in A/R top denial reasons use appropriate codes to be used in documentation of the reasons for denials / underpayments. MUST
• Record after-call actions and perform post call analysis for the claim follow-up. MUST
• Comply with terms of employment contract and company policies and procedures.

ModuleMD is an equal opportunity employer. We are dedicated to creating an inclusive, close-knit work environment where everyone is encouraged to be a part of the collaborative process and use individual strengths to shape their role at the company.

Interested candidates apply for this job or you can send your CV to:

Email ID: ashwitha.naidu@modulemd.com