Quality Auditor
Year Chandigarh, Chandigarh, India
Job Description
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Ideal candidate must have followed:
+91 6283479667
- 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.
- 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.
- Good knowledge of Microsoft 365 office applications like Teams, Outlook, CRM Dynamics, OneDrive etc.
- 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.
- Cell phone reimbursement
- Health insurance
- Paid sick time
- Performance bonus
- total work: 2 years (Preferred)
- Chandigarh, Chandigarh (Required)
- Chandigarh, Chandigarh: Relocate before starting work (Required)
+91 6283479667
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Job Detail
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Job IdJD3260340
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IndustryNot mentioned
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Total Positions1
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Job Type:Full Time
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Salary:Not mentioned
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Employment StatusPermanent
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Job LocationChandigarh, Chandigarh, India
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EducationNot mentioned
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ExperienceYear