Hospital Billing AR/Prior Authorization/Coder

Responsibilities for AR

- Make outbound calls to insurance companies to resolve outstanding claims

- Investigate and resolve billing discrepancies and denials

- Communicate with patients, providers, and insurance companies to resolve billing issues

- Meet productivity and quality standards

- Stay up-to-date with insurance policies, procedures, and regulations

- Collaborate with other team members to achieve departmental goals.

Responsibilities for Prior Authorization

- Obtain Prior Authorization from Insurance, providers for medical procedures, diagnosis tests, surgeries and prescription medications.

- Communicate with healthcare providers, insurance companies to gather the necessary information for Authorization.

- Review patient records and billing information to identify prior authorization requirements.

- Update patient records and billing systems with prior authorization information.

- Track the status of Authorization requests and follow up with insurance companies on pending approvals or denials.

- Resolve Authorization issues, appeals and discrepancies in a timely manner.

- Meet productivity and quality standards.

- Stay up-to-date with insurance policies, procedures, and regulations

Responsibilities for Coder

- Assign accurate and consistent codes for diagnoses and procedures

- Review hospital bills for coding accuracy and completeness

- Stay up-to-date with coding guidelines and regulations

- Collaborate with healthcare providers and other staff members

- Meet productivity and quality standards

- Ensure compliance with HIPAA and other regulatory requirements

Preferred candidate profile

Requirements for AR/ Prior Authorization

- 1+ year of experience in hospital billing, Denial Management and US Healthcare/ US Revenue Cycle Management, hospital billing Prior Authorization

- Strong communication and customer service skills

- Ability to work in a fast-paced environment and meet productivity standards

- Basic knowledge of medical terminology and billing procedures

- High school diploma or equivalent required; associate's or bachelor's degree preferred

Requirements for Coder

- Certified Professional Coder (CPC)

- 1+ years of hospital billing medical coding experience

- Strong knowledge of ICD-10-CM and CPT coding systems

- Excellent analytical and problem-solving skills

- Ability to work in a fast-paced environment

- Familiarity with electronic health records (EHRs) and billing systems

Perks and benefits

Competitive salary and benefits package

- Opportunities for professional growth and development

- Collaborative and dynamic work environment

- Recognition and rewards for outstanding performance