Job Description

Key Responsibilities: Review and resolve denied claims, ensuring timely follow-up with insurance providers. Work on CMS 1500 claim submissions, corrections, and reprocessing. Identify and analyze denials, take necessary actions, and resubmit claims as needed. Apply knowledge of Modifiers, Hoopa Guidelines, and insurance policies to maximize reimbursements. Handle AR follow-ups and maintain accurate documentation of interactions. Collaborate with internal teams to enhance billing processes and reduce denials. Meet productivity and quality benchmarks set by the company. Required Skills & Qualifications: Minimum 1year of experience in CMS 1500 claims processing. Strong expertise in Health care Management and AR calling. Familiarity with Physician Billing, Modifiers, and Hoopa Guidelines. Excellent communication and negotiation skills. Ability to work in a fast-paced, target-driven environment.