Billing Rejection Specialist

Overview

The Billing Rejection Specialist monitors clearinghouse portals, investigates medical claim rejections, corrects claim information, and resubmits claims while supporting accurate revenue cycle operations.

What you'll do

• Review and manage clearinghouse portals daily to capture, sort, and action front-end rejections.
• Contact insurance companies by phone or web portals to investigate complex claim rejections, verify active patient eligibility, and check benefit coverage details.
• Investigate whether claims were rejected because of demographic errors, missing insurance details, coding discrepancies, or provider credentialing mismatches.
• Update and correct patient demographics, insurance policy numbers, CPT/ICD-10 codes, and modifiers within practice management or EHR software before resubmitting claims.
• Partner with internal staff and internal medical coders to address data capture errors and help prevent recurring rejections.
• Maintain accurate logs of rejected claims, common rejection trends, and resolution turnaround times.
• Provide visibility to billing management.

What you'll need

• 1 to 3 years of professional experience in medical billing, revenue cycle operations, or high-volume healthcare administration.
• Hands-on familiarity with major clearinghouses and electronic health record (EHR) or practice management software, such as Waystar, Cortex, Epic, Athenahealth, eClinicalWorks, and NextGen.
• Exceptional attention to detail with strong alphanumeric data entry and verification skills.
• Solid foundational understanding of medical terminology.
• Solid foundational understanding of health insurance structures, including Medicare, Medicaid, and Commercial.
• Solid foundational understanding of CMS-1500 claim formats.
• Strong telephone etiquette and interpersonal communication skills for effective payer outreach.
• Analytical capability to diagnose billing errors independently.
• Proven ability and commitment to reliably work the 6:00 PM to 3:00 AM IST night shift schedule.
• High school diploma or equivalent.

Nice to have

• Associate's degree or general background in healthcare administration or medical billing.

Details

• Remote in India.
• Night shift: 6:00 PM to 3:00 AM IST.