Hiring Billing Executive / Claim Edits & Rejections / Hospital Billing

ECLAT Health Solutions; Hyderabad; On-site; INR 350,000 - 520,000; Full time

Job summary

ECLAT Health Solutions is hiring for Hospital Billing & Billing Exec / Sr Exec in Hyderabad. The role requires 1 to 5 years of experience in hospital billing, claims resolution, and strong knowledge of claim edits, rejections, Medicare plans, and payer requirements.

The candidate will identify billing errors, resolve rejections, ensure accurate claim submission, and coordinate with internal teams to maintain timely processing and compliance with payer rules.

Qualifications

• Experience in hospital billing and claims resolution.
• Knowledge of Medicare and Medicare Advantage billing guidelines.
• Ability to identify billing errors and resolve rejections.

Responsibilities

• Review and resolve claim edits and claim rejections.
• Handle Medical Necessity (MN) Rejections in hospital billing.
• Analyze and resolve Inclusive and Exclusive Edits.
• Work on Clearinghouse Rejections and Edits.
• Validate and correct: Payer ID issues, Invalid Member IDs, Provider NPI-related rejections, Invalid Payer IDs, Missing/Invalid Member IDs, Incorrect Provider NPI, Duplicate Claims, Edit Issues, MN Edit, and Invalid/Coded Diagnoses.
• Ensure accurate submission of hospital claims (UB-04).
• Review billing guidelines and coordinate with internal teams to ensure timely claim processing.

Skills

Billing & Claims Resolution

Claim Edits

Claim Rejections

Medicare Billing

Clearinghouse Edits

Payer Requirements

MN Rejections

Invalid Member ID

Invalid Payer ID

Provider NPI Issues

Duplicate Claim

Diagnosis/Procedure Codes

Job description

Hiring: Hospital Billing & Billing Exe / Sr Exe

Location: Hyderabad - Hitech City Department: Revenue Cycle Management (RCM) - Hospital Billing Experience: 1 to 5 Years

Job Summary

We are seeking experienced professionals in Hospital Billing and Claims Resolution with strong knowledge of claim edits, claim rejections, Medicare plans, clearinghouse edits, and payer requirements. The ideal candidate should possess expertise in identifying billing errors, resolving rejections, and ensuring accurate claim submission for maximum reimbursement.

Key Responsibilities

• Review and resolve claim edits and claim rejections.
• Handle Medical Necessity (MN) Rejections in hospital billing.
• Analyze and resolve Inclusive and Exclusive Edits.
• Work on Clearinghouse Rejections and Edits.
• Validate and correct:

• Payer ID issues
• Invalid Member ID errors
• Provider NPI-related rejections
• Invalid Payer ID
• Missing or Invalid Member ID
• Incorrect Provider NPI
• Duplicate Claim
• Inclusive/Exclusive Edit Issues
• Medical Necessity (MN) Edit
• Invalid Diagnosis or Procedure Code

• Ensure accurate submission of hospital claims (UB-04).
• Review Medicare and Medicare Advantage plan billing guidelines.
• Investigate denied and rejected claims and take corrective actions.
• Coordinate with internal teams to ensure timely claim processing.
• Maintain productivity and quality standards.
• Comply with payer regulations and billing requirements.