Claims Analyst

6 days ago


Hyderabad, Telangana, India beBeeHealthcare Full time ₹ 10,00,000 - ₹ 15,00,000

**Job Title:**

 
 

As a seasoned healthcare professional, you will be responsible for conducting thorough reviews of medical records and claims to ensure accuracy and compliance with contractual agreements.

 
 

Key Responsibilities include:

  • Reviewing itemized bills and supporting documentation for completeness and accuracy.
  • Verifying that billed services are supported by medical records and documentation.
  • Identifying duplicate charges, unbundling, upcoding, non-covered services, or charges inconsistent with guidelines and billing protocol.
  • Applying payer rules, federal/state regulations, and internal policies when evaluating charges.
  • Comparing charges against contracts, fee schedules, and usual & customary rates.
  • Working on appeals related to billing discrepancies.
  • Creating detailed documentation related to the above protocol.

 
 

**Qualifications:**

  • Certification in medical coding or auditing (CPMA preferred).
  • 3-4 years of experience in hospital billing, claims auditing, or insurance claims review.
  • Knowledge of legal and regulatory aspects of healthcare reimbursement.
  • Medical background with MBA/MHA preferred but not required.

 
 



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