Billing Rejection Specialist in भारत

This position is listed on behalf of a partner company, which manages all applications and next steps. Our partner is looking for a Billing Rejection Specialist based in India. We are seeking a detail-oriented Billing Rejection Specialist to support healthcare revenue cycle operations by identifying, investigating, and resolving rejected medical claims. In this remote role, you will monitor clearinghouse portals, communicate directly with insurance payers, and correct billing discrepancies to help ensure claims are processed accurately and efficiently. You will investigate rejection causes ranging from patient information errors and insurance eligibility issues to coding discrepancies and provider credentialing mismatches. Working closely with billing teams and medical coders, you will help prevent recurring errors, improve resubmission turnaround times, and maintain accurate records. Your work will contribute to smoother reimbursement workflows and stronger financial operations within a healthcare environment. This full-time opportunity is suited to a proactive problem-solver who can work independently, communicate professionally, and reliably support the required night shift from 6:00 PM to 3:00 AM IST. Accountabilities - Monitor clearinghouse rejections: Review clearinghouse portals daily to identify, categorize, prioritize, and action front-end claim rejections, ensuring issues are addressed promptly. - Communicate with insurance payers: Contact insurance companies by telephone or through online portals to investigate complex rejections, verify patient eligibility, confirm active insurance coverage, and clarify benefit details.

- Investigate rejection causes: Perform root cause analysis to identify issues involving patient demographics, missing or incorrect insurance information, medical coding discrepancies, provider credentialing mismatches, and other billing errors. - Correct and resubmit claims: Update patient demographic details, insurance policy numbers, CPT and ICD-10 codes, modifiers, and other claim information within electronic health record (EHR) or practice management systems before resubmission. - Collaborate with internal teams: Work closely with billing colleagues, medical coders, and relevant operational staff to resolve data capture errors, clarify coding issues, and reduce recurring claim rejections. - Maintain accurate records: Document rejected claims, investigation findings, corrective actions, resubmission status, and resolution timelines to ensure accurate tracking and accountability. - Identify rejection trends: Monitor recurring billing issues and rejection patterns, provide clear reporting to billing management, and contribute to process improvements that increase claim accuracy and operational efficiency. - Support timely reimbursement: Prioritize outstanding rejections and follow through on corrective actions to help reduce avoidable delays in the healthcare reimbursement cycle. Requirements - Professional experience: 1–3 years of experience in medical billing, healthcare revenue cycle operations, or high-volume healthcare administration. - Billing systems knowledge: Hands-on familiarity with major clearinghouse platforms and electronic health record or practice management systems, such as Waystar, Cortex, Epic, Athenahealth, eClinicalWorks, or NextGen. - Medical billing fundamentals: Foundational knowledge of medical terminology, health insurance structures, Medicare, Medicaid, commercial insurance plans, and CMS-1500 claim formats. - Claims processing expertise: Understanding of claim rejection workflows, eligibility verification, billing corrections, CPT and ICD-10 coding basics, insurance data validation, and claim resubmission procedures.