Billing Executive

We are looking for a detail-oriented Billing Executive to manage medical billing, insurance claim submission and follow-up, denial management, appeals, and patient account audits. The role requires ensuring billing accuracy, timely reimbursement, regulatory compliance, and effective resolution of claim and payment discrepancies.

• Key ResponsibilitiesPrepare, review, and submit accurate medical bills and insurance claims within established timelines.
• Monitor claim status and follow up with insurance companies, TPAs, and other payers to ensure timely reimbursement.
• Review denied, rejected, and underpaid claims to identify the underlying causes and required corrective actions.
• Prepare and submit claim appeal letters along with relevant clinical, medical, and billing documentation.
• Coordinate with medical records, coding, and clinical teams to resolve billing and claim denial issues.
• Monitor appeal status and maintain accurate records of appeal outcomes and resolutions.
• Conduct audits of patient accounts to verify charges, payments, adjustments, write-offs, and outstanding balances.
• Identify billing discrepancies, revenue leakage, process gaps, and potential compliance risks.
• Ensure billing and claims activities comply with payer contracts, regulatory requirements, and internal policies.
• Recommend and implement corrective actions based on audit and billing findings.
• Communicate with insurance companies, TPAs, and payers regarding claims, appeals, eligibility, authorization, and payment discrepancies.
• Verify patient insurance eligibility, coverage, benefits, and authorization requirements when necessary.
• Accurately post insurance and patient payments, adjustments, and write-offs in the billing system.
• Prepare and maintain aging, denial, claim, payment, and audit reports for management review.
• Support month-end billing activities, account reconciliation, and audit closure processes.
• Identify opportunities to improve billing and denial management processes to increase revenue, improve collections, and reduce claim denials.
• Maintain accurate documentation and ensure confidentiality of patient and billing information.
• Required QualificationsBachelor’s degree in Commerce, Accounting, Healthcare Administration, or a related field.
• 2–5 years of experience in medical billing, healthcare claims processing, denial management, or appeals. Freshers with relevant knowledge may also apply.
• Good understanding of medical billing and insurance claim processes.
• Strong analytical, problem-solving, and attention-to-detail skills.
• Good written and verbal communication skills.
• Ability to work independently and effectively coordinate with internal and external stakeholders.
• Proficiency in MS Office and familiarity with billing or healthcare management systems is preferred.