Medical Billing Executive

Medical Billing Executive

Customer service and medical billing professional with experience in international medical billing, healthcare claims processing, insurance verification, and denial management. Skilled in coordinating with insurance companies, healthcare providers, doctors, and patients to resolve billing discrepancies, verify medical records, track claim statuses, and manage prior authorizations. Experienced in handling approximately 30 follow-up calls daily while maintaining accuracy, meeting productivity targets, and adhering to compliance standards.

Roles and Responsibilities

·        To make calls to insurance companies, doctors, hospitals, and patients to verify medical records, check claim statuses, update prior authorizations, and resolve claim denials.

·        Reviewed and analysed medical billing discrepancies to identify the root causes of claim rejections and denials.

·        Verified insurance eligibility, benefits, and coverage details to ensure accurate claim processing.

·        Followed up with insurance providers regarding pending, rejected, and denied claims to ensure timely resolution and reimbursement.

·        Coordinated with healthcare providers and insurance companies to obtain missing medical records, supporting documents, and claim-related information.

·        Verified physician and hospital NPI numbers, CPT/ICD billing codes, medical records, and claim documentation for accuracy.

·        Assisted in prior authorization follow-ups and updates to ensure required approvals were obtained before claim submission.

·        Applied knowledge of insurance plans, medical billing procedures, claim processing, and denial management to minimize billing errors.

·        Maintained accurate documentation of all calls, follow-ups, claim updates, and billing-related activities in accordance with company policies and compliance standards.

·        Handled sensitive patient and insurance information with confidentiality and accuracy.

·        Consistently achieved daily productivity targets and administrative deadlines while maintaining quality and accuracy.

·        Collaborated with internal teams to improve workflow efficiency, resolve outstanding claims, and ensure smooth billing operations.

Key Skills

·        International Medical Billing

·        Healthcare Claims Processing

·        Insurance Verification and Eligibility

·        Claim Follow-up and Status Tracking

·        Denial Management

·        Prior Authorization

·        NPI Verification

·        CPT and ICD Coding Verification

·        Medical Records and Documentation

·        Billing Discrepancy Resolution

·        Insurance Coordination

·        Patient and Provider Communication

·        HIPAA Compliance Awareness

·        Customer Service and Problem Resolution

·        Productivity and Quality Management

Languages: English, Bengali, and Hindi.