Medical Billing Auditor

Role & responsibilities

Ensure the accuracy and integrity of medical billing processes. The focuses on identifying and preventing billing discrepancies, errors, and potential revenue loss. By thoroughly reviewing and verifying medical claims, the auditor helps safeguard against inaccuracies and ensures compliance with industry standards, ultimately promoting efficiency and preventing financial leakages.

Preferred candidate profile

• Ability to thoroughly review and compare patient files, medical records, and billing data to identify discrepancies. for all planned discharges and high value/ALOS/ICU patients.
• Ability to analyze data and track trends in deductions, billing errors, or overbilling issues.
• Ensuring updating of billing specially credit billing on daily basis
• Control deductions that arise due to incorrect billing or overbilling
• Review medical records and compare them with the billing to ensure that all charges are accurate and reflective of the care provided.
• Ensure that accurate billing practices are followed to prevent the same errors from occurring in the future.
• Monitoring of all order items to ensure no under or over charging happens
• Correlating Medical records and patients billing to ensure billing is in sync with the medical treatment.
• Coordinating with MRD/Nursing/Medical Team/TPA to ensure credit bills are dispatched in accordance with the MOUs/Agreements with TPAs/Corp/PSU clients
• Ensuring real time monitoring of deductions. maintaining a proper tracker having relevant reasons of such deductions and follow-up with concerned stakeholders ( IPD billing, medical/Ops teams/collections/TPA cells/MRD for quick resolution of such deductions.
• Deductions arising due to incorrect billing, over billing etc.. to be controlled to ensure accurate billing for such cases in future to avoid repetitive similar deductions.

Education - BDS + MHA/ MBA (NON- medical education background candidates are requested to not apply)

Interested candidates may connect on +91- 7678607745