AR Associates/Senior Assocites

Eclat Health Solutions; Mumbai, Navi Mumbai; On-site; INR 350,000 - 550,000; Full time

Job summary

Eclat Health Solutions in Mumbai seeks an experienced Physician Billing Associate to prepare, review, and submit CMS-1500 and UB04 medical claims to U.S. payers, ensuring timely reimbursement while maintaining HIPAA compliance.

The ideal candidate has 1-5 years' billing experience, knowledge of Medicare/Medicaid guidelines, and proficiency with Epic, Kareo, or eClinicalWorks. This role requires attention to detail and the ability to work independently.

Qualifications

• Experience in physician or hospital billing with CMS-1500 or UB04 claims.
• Knowledge of Medicare, Medicaid, and commercial insurance guidelines.
• Familiarity with EHR and billing systems (Epic, Cerner, Meditech).
• Detail-oriented with strong problem-solving and deadline awareness.

Responsibilities

• Review and follow up on unpaid or denied insurance claims (primary and secondary).
• Analyze EOBs and Remittance Advice to determine action.
• Contact insurance companies to resolve claims and secure payments.
• Work denials and rejections in a timely manner and re-submit corrected claims as needed.
• Perform AR follow-up via phone calls, portals, and payer websites.
• Ensure compliance with HIPAA regulations and payer-specific billing requirements.
• Collaborate with coding and billing teams to resolve discrepancies or missing documentation.
• Update claim status and notes in the billing system (EPIC, Kareo, eClinicalWorks).
• Meet productivity and quality targets.

Skills

Detail-oriented

Problem-solving

Independent work

Deadline-driven

Education

High School Diploma

Associate's degree preferred

Tools

EPIC

Kareo

eClinicalWorks

CMS-1500 processing

Job description

Job Summary:

We are looking for experienced Physician Billing Associates/Hospital Billing Associates to join our growing team in Mumbai. The ideal candidate will be responsible for preparing, reviewing, and submitting accurate medical claims (CMS-1500), (UB04) to insurance payers, ensuring timely reimbursements, and maintaining compliance with U.S. healthcare billing standards.
Key Responsibilities:

• Review and follow up on unpaid or denied insurance claims (primary and secondary).
• Analyze Explanation of Benefits (EOBs) and Remittance Advice (RA) to determine appropriate action.
• Contact insurance companies to resolve claims issues and secure payments.
• Work denials and rejections in a timely manner and re-submit corrected claims as needed.
• Perform AR follow-up via phone calls, portals, and payer websites.
• Ensure compliance with payer-specific billing requirements and HIPAA regulations.
• Collaborate with coding and billing teams to resolve discrepancies or missing documentation.
• Update claim status and notes in the billing system (e.g., EPIC, Kareo, eClinicalWorks).
• Meet productivity and quality targets (e.g., number of claims worked per day, resolution rate).

Requirements:

• High School Diploma or equivalent (Associate's degree preferred).
• 1-5 years of experience in Physician billing, with emphasis on CMS-1500 OR Hospital Billing claim processing.
• Knowledge of Medicare, Medicaid, and commercial insurance guidelines.
• Familiarity with EHR and billing systems (e.g., Epic, Cerner, Meditech).
• Detail-oriented with strong problem-solving skills.
• Ability to work independently and meet deadlines.