Medical / Clinical Reviewer - Physical / Speech Therapist

Allcaretherapies; Chennai; On-site; INR 3,00,000 - 7,00,000; Full time

Job summary

An established industry player is seeking a dedicated Medical / Clinical Reviewer to ensure compliance with insurance standards and enhance billing accuracy. This role is pivotal in safeguarding financial integrity and ensuring timely reimbursements. The ideal candidate will conduct thorough audits, collaborate with clinicians, and stay updated on regulatory changes. Join a dynamic team that values innovation and excellence in healthcare management, where your contributions will directly impact the quality of service provided to patients and the efficiency of operations.

Benefits

Group Health Insurance

Leave Encashment on Gross

Yearly Bonus

12 Paid Indian & US Holidays

Qualifications

• Bachelor's degree in relevant field or equivalent work experience.
• Experience in medical billing, coding, or auditing preferred.

Responsibilities

• Conduct pre-billing audits to ensure compliance with insurance standards.
• Provide feedback to clinicians on documentation improvements.
• Collaborate with billing department to resolve claims issues.

Skills

Analytical Skills

Communication Skills

Attention to Detail

Knowledge of Medical Terminology

Knowledge of Insurance Billing Practices

Education

Bachelor's degree in Physical Therapy

Certification in Medical Billing and Coding

Tools

Electronic Health Record (EHR) Systems

Billing Software

Job description

Medical / Clinical Reviewer - Physical / Speech Therapist

• Full-time
• Department: Provider Network

All Care Therapies is a rapidly growing IT and Medical back office Management Company. We provide superior consulting and management services for the healthcare industry. All Care Therapies brings a fresh and innovative approach to back office healthcare management.

We are looking for dynamic and enthusiastic HR Executive with experience in US Medical Billing Industry, to support our HR team. If you are a success driven individual, an aggressive go-getter with positive attitude, good communication and excellent rapport building skills, then we would like to consider you.

Job Title: Medical / Clinical Reviewer - Physical / Speech Therapist
Location: Chennai, TN
Positions Numbers: 8 Nos.
Position Type: Full-Time / Part-Time

Job Summary:
The Medical Reviewer will be responsible for conducting pre-billing audits to ensure all documentation and billing submissions comply with insurance standards and regulatory requirements. This role is critical in safeguarding the financial integrity of the practice and ensuring timely reimbursement from insurance providers.

Key Responsibilities:

• Conduct comprehensive pre-billing audits on patient records to verify that services are documented accurately and align with insurance guidelines.
• Ensure all therapy notes and coding are accurate, complete, and in compliance with insurance and regulatory standards.
• Work with clinician to identify and rectify discrepancies or errors in documentation and billing submissions.
• Provide feedback to clinicians and administrative staff regarding documentation improvements and compliance requirements.
• Stay updated on changes in insurance policies, billing codes, billing modifiers and regulatory requirements affecting therapy services.
• Collaborate with the billing department to resolve any issues related to claims denials or rejections.
• Prepare detailed reports on audit findings and recommend corrective actions as needed.
• Assist in developing and implementing internal policies and procedures related to billing and documentation standards.

Minimum Qualifications:

• Bachelor's degree in physical therapy, speech therapy, occupational therapy, or a related field; relevant work experience may be considered in lieu of a degree.
• Previous experience in medical billing, coding, or auditing within a healthcare setting, preferably in therapy.
• Certification in medical billing and coding (e.g., CPC, CCS, or equivalent) is preferred.
• Strong knowledge of insurance billing practices, medical terminology, and regulatory standards in the US.
• Excellent analytical skills and attention to detail.
• Strong communication skills, with the ability to provide clear feedback and guidance to clinical and administrative staff.
• Proficiency in using electronic health record (EHR) systems and billing software.

Benefits:

• Group Health Insurance
• Leave Encashment on Gross
• Yearly Bonus
• 12 Paid Indian & US Holidays

All Care Therapies is an equal opportunity employer. All aspects of employment, including the decision to hire, promote, discipline, or discharge, will be based on merit, competence, performance, and business needs. We do not discriminate based on race, color, religion, marital status, age, national origin, ancestry, physical or mental disability, medical condition, pregnancy, genetic information, gender, sexual orientation, gender identity or expression, veteran status, or any other status protected under federal, state, or local law.