Billing Rejection Specialist

harriscomputer; India; Remote; INR 350,000 - 600,000; Full time

Job summary

Harris Computer is seeking a medical billing specialist to monitor clearinghouses and engage with payers. The role requires investigation of complex claim rejections, accurate data corrections in EHR/PMS, and collaboration with internal teams to reduce future issues.

Night shift from 6:00 PM to 3:00 AM IST will be required, with remote work options in India. The ideal candidate has 1–3 years of experience in medical billing and strong knowledge of Medicare, Medicaid, and commercial payers, plus

Qualifications

• High school diploma or equivalent required; Associate’s degree preferred in healthcare administration or medical billing.
• 1–3 years of experience in medical billing, revenue cycle, or healthcare administration.
• Experience with major clearinghouses and EHR/practice management software.

Responsibilities

• Clearinghouse monitoring: daily review and action on front-end rejections.
• Direct payer communication to investigate complex rejections and verify eligibility.
• Root cause analysis of rejections due to demographic, insurance, coding, or credentialing issues.
• Claim correction and resubmission of demographics, policy numbers, CPT/ICD-10 codes, and modifiers in EHR/PMS.
• Collaborate with internal staff and coders to address data capture errors and prevent recurring rejections.
• Maintain logs of rejected claims, trends, and resolution turnaround times for management visibility.

Skills

Attention to detail

Strong communication

Problem-solving

Analytical thinking

Shift flexibility

Education

High school diploma

Associates degree preferred

Tools

Waystar

Cortex

Epic

Athenahealth

eClinicalWorks

NextGen

Job description

Key Responsibilities

• Clearinghouse Monitoring: Daily review and management of clearinghouse portals to capture, sort, and action front-end rejections.
• Direct Payer Communication: Contact insurance companies directly via phone or web portals to investigate complex claim rejections, verify active patient eligibility, and check benefit coverage details.
• Root Cause Analysis: Investigate why claims were rejected by the clearinghouse or payer, distinguishing between demographic errors, missing insurance details, coding discrepancies, and provider credentialing mismatches.
• Claim Correction & Resubmission: Efficiently update and correct patient demographics, insurance policy numbers, CPT/ICD-10 codes, and modifiers within the practice management or EHR software before resubmitting.
• Cross-Functional Collaboration: Partner with internal staff and internal medical coders to address data capture errors and help prevent recurring rejections.
• Tracking & Reporting: Maintain accurate logs of rejected claims, common rejection trends, and resolution turnaround times, providing visibility to billing management.

Qualifications & Skills

• Experience: 1 to 3 years of professional experience in medical billing, revenue cycle operations, or high-volume healthcare administration.
• Technical Proficiency: Hands-on familiarity with major clearinghouses and electronic health record (EHR) / practice management software (e.g., Waystar, Cortex, Epic, Athenahealth, eClinicalWorks, NextGen).
• Data Accuracy: Exceptional attention to detail with strong alphanumeric data entry and verification skills.
• Industry Knowledge: Solid foundational understanding of medical terminology, health insurance structures (Medicare, Medicaid, Commercial), and CMS-1500 claim formats.
• Problem-Solving & Communication: Strong telephone etiquette and interpersonal communication skills for effective payer outreach, alongside analytical capability to diagnose billing errors independently.
• Shift Flexibility: Proven ability and commitment to reliably work the 6:00 PM to 3:00 AM IST night shift schedule.

Education & Credentials

• High school diploma or equivalent required; Associate's degree or general background in healthcare administration or medical billing preferred.
• Shift: Night Shift (6:00 PM - 3:00 AM IST) -Remote India