Medical Billing Auditor

Nextenti Tech; Kozhikode district; On-site; INR 800,000 - 1,600,000; Full time

Job summary

Nextenti Tech is seeking a detail-oriented Medical Billing Auditor to review hospital billing records, ensure accuracy, verify insurance details, and support the billing team in maintaining compliance with guidelines.

Responsibilities include auditing statements, validating patient and treatment data, and coordinating with doctors, departments, and insurers to resolve discrepancies. Prior experience in hospital billing and medical coding is advantageous.

Qualifications

• Formal qualification as listed (B.Com/BBA/B.Sc/B.Pharm or equivalent).
• Certification in Medical Billing / Medical Coding preferred.
• Experience in hospital billing, medical billing, insurance, TPA, or RCM is advantageous.

Responsibilities

• Review and audit hospital billing statements for accuracy, completeness, and compliance.
• Verify patient details, treatment information, procedures, and billing documents.
• Check billing records against hospital guidelines and insurance policies.
• Identify billing discrepancies, duplicate charges, incorrect entries, and missing information.
• Coordinate with doctors, nurses, hospital departments, billing teams, and insurance/TPA representatives to resolve issues.
• Review insurance claims and supporting documentation for accuracy.
• Ensure proper application of medical billing and coding standards.
• Maintain accurate records of billing audits, discrepancies, and corrections.
• Assist in preparing billing reports, audit reports, and financial statements.
• Communicate with patients and insurance companies regarding billing queries when required.
• Monitor billing data using hospital billing software, HIS, ERP, or other systems.
• Support the billing department in improving processes and reducing billing errors.
• Maintain confidentiality of patient and financial information.
• Stay updated on healthcare billing regulations, insurance requirements, and medical coding practices.

Skills

Medical / Hospital Billing

Billing Audit

Insurance & TPA Coordination

Medical Coding

Claims Processing

Billing Verification

Revenue Cycle Management (RCM)

MS Excel

Hospital Information System (HIS)

Analytical & Communication skills

Attention to detail

Education

B.Com / BBA / B.Sc / B.Pharm or equivalent qualification

Certification in Medical Billing / Medical Coding

Tools

MS Excel

Hospital Information System (HIS)

Job description

Job Summary

We are looking for a detail-oriented Medical Billing Auditor to review and audit hospital billing records, ensure billing accuracy, verify insurance-related information, identify discrepancies, and support the billing team in maintaining compliance with hospital and insurance guidelines.

Key Responsibilities

• Review and audit hospital billing statements for accuracy, completeness, and compliance.
• Verify patient details, treatment information, procedures, and billing documents.
• Check billing records against hospital guidelines and insurance policies.
• Identify billing discrepancies, duplicate charges, incorrect entries, and missing information.
• Coordinate with doctors, nurses, hospital departments, billing teams, and insurance/TPA representatives to resolve billing issues.
• Review insurance claims and supporting documentation for accuracy.
• Ensure proper application of medical billing and coding standards.
• Maintain accurate records of billing audits, discrepancies, and corrections.
• Assist in preparing billing reports, audit reports, and financial statements.
• Communicate with patients and insurance companies regarding billing-related queries when required.
• Monitor billing data using hospital billing software, HIS, ERP, or other relevant systems.
• Support the billing department in improving processes and reducing billing errors.
• Maintain confidentiality of patient and financial information.
• Stay updated on healthcare billing regulations, insurance requirements, and medical coding practices.

Qualification

• B.Com / BBA / B.Sc / B.Pharm or equivalent qualification
• Certification in Medical Billing / Medical Coding is preferred.
• Prior experience in hospital billing, medical billing, insurance, TPA, or RCM will be an advantage.

Required Skills

• Medical / Hospital Billing
• Billing Audit
• Insurance & TPA Coordination
• Medical Coding
• Claims Processing
• Billing Verification
• Revenue Cycle Management (RCM)
• MS Excel
• Hospital Information System (HIS)
• Good analytical and communication skills
• Strong attention to detail

Preferred Experience

13 years of experience in hospital billing, medical billing, insurance, TPA, or RCM.

Preferred Candidate

Candidates with experience in hospital billing audit, insurance claims, TPA coordination, medical coding, or RCM operations are preferred.