Senior Healthcare Claims Auditor

7 days ago

Kota, Rajasthan, India beBeeMedical Full time ₹ 40,00,000 - ₹ 50,00,000
Experienced Medical Billing Specialist

We are seeking a skilled and detail-oriented Medical Billing Specialist to join our organization and contribute to efficient revenue cycle management.

Key Responsibilities:

  • Manage accurate and timely processing of claims, ensuring compliance with payer guidelines and regulations.
  • Review and address billing discrepancies, rejections, and denials, implementing corrective actions as needed.
  • Develop and implement billing policies and procedures to improve accuracy and efficiency.
  • Collaborate with coding, compliance, and other departments to ensure accurate coding and documentation.
  • Analyse billing data and metrics to identify trends, issues, and opportunities for process improvements.
  • Ensure proper follow-up on unpaid or denied claims and manage the appeals process.
  • Oversee the use of billing software and electronic health record (EHR) systems, ensuring they are up-to-date and functioning properly.
  • Stay informed about changes in U.S. revenue cycle management practices and federal regulations to ensure billing processes remain compliant and optimized.
  • Provide guidance and training to the team on evolving industry standards and policy updates.

Requirements:

  • Bachelor's degree in business administration, Healthcare Administration, Finance, or a related field is required. Advanced degrees or certifications are a plus.
  • Proven experience with billing systems, payer guidelines, and regulatory compliance.
  • Strong understanding of U.S. revenue cycle management, including billing workflows, reimbursement methodologies, and common challenges.
  • Up-to-date knowledge of federal regulations, policy changes, and industry standards impacting medical billing practices.
  • Familiarity with billing software and electronic health records (EHR) systems.
  • Strong attention to detail, analytical skills, and ability to work independently.
  • Excellent communication and collaboration skills.

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