SME

Experience with in hospital billing (UB\-04) with IPA & Commercial claims processing<\/span>
<\/p>

At least 3 years of experience in hospital billing &<\/span> <\/span>Proficient in Payment systems <\/span>
<\/p>

Analyze and address complex denials, rejections, and underpayments while serving as a process expert in AR workflows, payer guidelines, and billing systems. <\/span>
<\/p>

Conduct root cause analysis for recurring issues and propose corrective actions to ensure compliance with turnaround time, productivity, and quality standards. <\/span>
<\/div>

Assist the team with escalated issues and client inquiries, providing feedback and coaching to enhance team performance. <\/span>
<\/p>

Support the training of new employees and promote ongoing knowledge sharing within the team. <\/span>
<\/p>

Collaborate with internal departments, such QA, Training team to resolve issues and prepare daily and weekly performance reports. <\/span>
<\/p>

<\/div><\/span>

Requirements<\/h3>
Experience with hospital billing (UB\-04) with IPA & Commercial claims processing<\/span>
<\/p>
Strong knowledge in inpatient (IP) and outpatient (OP) billing workflows,<\/span> d<\/span>enial management and appeals process<\/span>
<\/p>
At least 2 years of experience in medical billing, specializing in Payment systems and contract sheet validation (IPPS & OPPS, APC Fees Schedule, DRG & APRDRG)<\/span>
<\/p>
In\-depth knowledge of Hospital Billing Accounts Receivable processes, including Denial Management and Appeals. <\/span>
<\/p>
Proficient in analyzing EOB/ERA and understanding payer guidelines for Medicare, Medicaid, and Commercial plans. <\/span>
<\/p>
Familiar with various payment methodologies such as IPPS, OPPS, DRG/APR\-DRG, and APC Fee Schedule. <\/span>
<\/p>
Experienced in managing high\-value and aged accounts receivable with strong analytical and problem\-solving abilities. <\/span>
<\/p>
Effective communicator with the capability to mentor and support team members. <\/span>
<\/p>
<\/span>
<\/p>
Interested candidates can send their updated resumes to: twinkleamaldia<\/u><\/b><\/span>@<\/u>shai.health<\/span><\/b><\/a><\/span>
<\/p>
(Mail subject line: "<\/span>Applying for Experienced Hospital Billing Executive\u201d <\/span><\/b>for any quires call to this number 9500202989).<\/span>
<\/p>

<\/div><\/span>