
Billing/authorization Associate
23 hours ago
**Location**: Ahmedabad
**Job Type**: Full-Time
**Salary**: ₹20,500 - ₹40,000 per month
**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)
Pay: ₹20,500.00 - ₹40,000.00 per month
**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)
Work Location: In person
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