Quality Auditor

6 days ago

Chandigarh, India Brandz Venture Pvt Ltd Full time

Responsible for Data Entry, Patients Collections, Charges, Denials, Rejections, Eligibility verification, Insurance Processing, Payment Posting, Customer Service duties.
- Responsible for 100% audit of all charge entry claims and payments posted.
- Delivery of team target, service level components, quality & indicators.
- Must have insurance verification experience including HMOs, PPOs, and POS.
- Interact with the US-based insurance carriers to follow-up on submitted claims, monitor unpaid claims, delayed processing, and underpayment plan, and execute medical insurance claim denial appeal process.
- Review EOB/ERA denials and Patient history notes to understand and resolve denial on a claim.
- Responsible for training team members and ensuring production and quality targets are met as per assigned KRAs.
- Responsible for publishing regular management reports on quality metrics of team.

**Required skills**:

- Experience of QA/Audits and Team management, client interaction/client account management will be big plus.
- Must have at least 5+ yrs. experience in physician billing; specifically, chiropractic, mental health, behavioral health, nephrology etc.
- Understand CMS-1500 and UB-04 claim formats. Typing speed, at least 45 WPM.
- Third party payer requirements. Account management experience will be a big plus.
- Must have knowledge of medical billing software, preferably Kareo,/Tebra, Epic, Therapy Notes, Simple Practice, YouthCare, Theranest or any other similar.

**Competencies**:

- Excellent verbal and written English business communication skills for interacting with USA based team members/ physicians/patients.
- Professional and able to make a great impression on the phone. Required to understand, communicate & work regularly with USA based team.
- Ability to work well with others and facilitate teamwork and cooperation. Positive attitude and able to follow directions.
- Willing to cross train and cross learn other areas of RCM.
- Tact, diplomacy, and the ability to maintain confidentiality of company, client, and patient information.
- Must have very strong work ethic and excellent attention to detail.

**Salary**: ₹14,047.49 - ₹34,709.26 per month

**Benefits**:

- Cell phone reimbursement
- Health insurance
- Paid sick time

Supplemental pay types:

- Performance bonus

**Experience**:

- total work: 2 years (preferred)

Ability to Commute:

- Chandigarh, Chandigarh (required)

Ability to Relocate:

- Chandigarh, Chandigarh: Relocate before starting work (required)

Work Location: In person

**Speak with the employer**

+91 6283479667

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