Billing/ Authorization Executive

4 days ago

Ahmedabad Gujarat, India Intelligent Medical Billing Solutions Full time

**Job description(Auth/billing)**

**Location**: Ahmedabad

**Job Type**: Full-Time

**Schedule**:

- Day Shift / Night Shift / US Shift
- Monday to Friday

**Job Summary**:
**Key Responsibilities**:

- **Insurance Verification**: Check and verify patients’ insurance coverage, eligibility, and benefits for medical services.
- **Authorization Process**: Request and obtain pre-authorization and pre-certification from insurance companies for procedures, diagnostics, treatments, and equipment.
- **Medical Necessity Review**: Evaluate provider documentation to confirm medical necessity and ensure alignment with insurance policies.
- **Medical Billing**: Prepare and process accurate medical bills with correct codes (ICD, CPT, HCPCS) in accordance with payor guidelines.
- **Claims Submission**: Submit claims and authorization requests electronically or via other required channels with complete supporting documentation.
- **Follow-Up**: Track the status of authorizations and claim submissions; follow up on pending requests and denials.
- **Issue Resolution**: Communicate with insurance companies to resolve denied or delayed authorizations and work closely with the internal billing team to clarify discrepancies.
- **Record Keeping**: Maintain updated records of all authorizations, billing details, approvals, denials, and communications.
- **Compliance**: Adhere to healthcare compliance standards including HIPAA and ensure all activities follow industry regulations and company protocols.
- **Team Coordination**: Collaborate with other departments to ensure smooth billing cycles and optimal patient service delivery.
- **Knowledge Upkeep**: Stay updated with insurance policy changes, coding updates, and best practices in medical billing.

**Qualifications**:

- Minimum **1 year of experience** in medical billing/authorization (preferred).
- Strong **understanding of medical coding** (ICD, CPT, HCPCS).
- Familiarity with insurance authorization procedures and claim workflows.
- Good communication and coordination skills.
- Proficiency in EHR/medical billing software.
- Detail-oriented with strong problem-solving skills.

**Benefits**:

- Provident Fund
- Performance Bonus
- Joining Bonus (If Applicable)

**Benefits**:

- Flexible schedule
- Leave encashment
- Paid sick time
- Provident Fund

Schedule:

- Evening shift
- Fixed shift
- UK shift
- US shift

Supplemental Pay:

- Joining bonus

Ability to commute/relocate:

- Makarba, Ahmedabad, Gujarat: Reliably commute or planning to relocate before starting work (preferred)

**Education**:

- Bachelor's (preferred)

Shift availability:

- Night Shift (preferred)

**Job Types**: Full-time, Permanent

Pay: ₹19,044.82 - ₹37,258.07 per month

**Benefits**:

- Leave encashment
- Paid sick time
- Paid time off
- Provident Fund

Schedule:

- Evening shift
- Monday to Friday
- Night shift

Work Location: In person

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