Key Requirements

• 5+ years of experience as a Team Lead
• Strong knowledge of E/M coding
• Expertise in CPT, ICD-10 & coding guidelines
• Specialized in Podiatry and Wound Care Management
• Good communication and leadership skills

Key Responsibilities

• Handle end-to-end team performance, productivity, and quality metrics
• Provide SME support to Quality Analysts and team members
• Ensure SLA adherence and operational efficiency
• Manage attendance, discipline, and performance improvement plans
• Act as SPOC for team members and maintain team engagement
• Conduct regular team meetings and training sessions
• Manage client communication and process updates
• Supervise daily workflow, task allocation, and performance evaluation

Job Description

• Review and analyze denied claims, identifying root causes and trends in denials
• Research payer-specific denial reasons and ensure accurate coding and documentation practices
• Work with internal teams (e.g., billing, coding, and clinical staff) to correct errors and resolve denials
• Collaborate with insurance payers to resolve issues and appeal denials when appropriate
• Maintain accurate records of denied claims, appeals, and outcomes for tracking purposes
• Maintaining a TAT of 48hrs to address the denials that are captured in the denial log
• Keep track of the denials that are assigned to the various departments and ensure timely competition
• Escalate the denials that are pending (exceeding TAT) with other departments to the GC/TL
• Working on Global denials towards resolution and notifying the Lead, Managers on the same via email or other channels for effective tracking and implementing preventive measures
• Minimizing Denial Aging by prioritizing older claims and working them towards resolutions with minimum actions / steps
• Reaching out to insurance via call if required to find a solution or update
• Participate in team meetings and voice out the issues / updates in their respective projects for quicker resolution and disseminating the ideas with the team
• Collaborating with team members to share the recent trends, ideas, work flow update, practice updates, thereby fostering a healthy work environment
• Maintain 100 % quality on a daily basis
• Collaborate with the QCA and complete the reworks, if any, in a timely fashion
• Incorporate feedback from the Quality team into your daily practice to ensure you do not repeat previously identified mistakes
• Adhere to company policies, insurance payer guidelines, and industry regulations when resolving denials and handling sensitive information
• Maintain confidentiality of all patient and claim data in compliance with HIPAA and other regulatory standards

Educational Qualification

• Bachelor's degree in any discipline
• Fresh graduates are welcome to apply for the Trainee position
• 0–2 years of experience in Revenue Cycle Management (RCM), Healthcare BPO, or Healthcare Operations is an added advantage

Required Skills

• Strong verbal and written communication skills
• Good analytical and problem-solving abilities
• Basic understanding of the Revenue Cycle Management (RCM) process is preferred
• Ability to learn new healthcare systems, applications, and processes quickly
• Excellent organizational and documentation skills
• Strong attention to detail with a focus on accuracy
• Ability to work effectively in a team and collaborate with cross-functional departments
• Willingness to work in rotational shifts, if required

Key Competencies

• Quick learner with a positive attitude
• Strong time management and multitasking abilities
• Ability to manage multiple transition activities simultaneously
• Adaptability to changing business requirements and client expectations
• Customer-focused mindset with a commitment to quality
• Ability to maintain confidentiality and comply with HIPAA and organizational policies

Preferred Knowledge

• Basic knowledge of the US Healthcare system
• Understanding of medical billing, medical coding, claims processing, payment posting, AR follow-up, or insurance verification is an advantage
• Familiarity with process documentation, Standard Operating Procedures (SOPs), and knowledge transfer activities is desirable
• Awareness of quality standards and process improvement methodologies is a plus

Educational Qualification

• Bachelor's degree in any discipline
• 1–3 years of experience in US Healthcare Credentialing or Provider Enrollment is preferred
• Freshers with strong communication skills who are interested in building a career in the Revenue Cycle Management (RCM) industry are also welcome

Required Skills

• Strong understanding of the provider credentialing and re-credentialing process
• Knowledge of provider enrollment with commercial insurance payers, Medicare, and Medicaid
• Familiarity with CAQH profile management and provider data maintenance
• Excellent verbal and written communication skills
• Strong attention to detail and organizational skills
• Ability to manage multiple provider applications and meet deadlines
• Good analytical and problem-solving abilities

Key Competencies

• Excellent documentation and record management skills
• Ability to coordinate effectively with providers, payers, and internal teams
• Strong follow-up and negotiation skills
• Ability to work independently as well as in a collaborative team environment
• High level of accuracy and commitment to quality
• Adaptability to changing payer requirements and organizational processes

Preferred Knowledge

• Working knowledge of US Healthcare and Revenue Cycle Management (RCM)
• Experience with credentialing software and provider management systems
• Knowledge of NPI, PECOS, CAQH, NPPES, and payer portals
• Understanding of provider licensing, malpractice insurance, board certifications, DEA, and state registrations
• Familiarity with HIPAA compliance and healthcare regulations

Additional Requirements

• Ability to prioritize multiple credentialing tasks and meet turnaround timelines
• Strong customer service mindset when interacting with providers and clients
• Willingness to work in a fast-paced environment and adapt to business needs
• Commitment to maintaining confidentiality and data accuracy
• Continuous learning mindset to stay updated with payer guidelines and credentialing regulations

Educational Qualification

• Bachelor's degree or equivalent qualification in any discipline
• CPC (Certified Professional Coder) or CCS (Certified Coding Specialist) certification is mandatory
• 1–3 years of experience in Medical Coding for Medical Coder
• 3+ years of relevant experience in Medical Coding for Senior Medical Coder

Required Skills

• Strong knowledge of ICD-10-CM, CPT, and HCPCS coding guidelines
• Ability to accurately review medical records and assign appropriate diagnosis and procedure codes
• Good understanding of anatomy, physiology, medical terminology, and disease processes
• Knowledge of coding compliance, payer-specific guidelines, and documentation requirements
• Proficiency in Electronic Health Records (EHR) and medical coding software
• Strong analytical, problem-solving, and decision-making skills
• Excellent attention to detail with a high level of coding accuracy
• Good verbal and written communication skills

Key Competencies

• Ability to meet productivity and quality targets
• Strong organizational and time management skills
• Ability to work independently and collaboratively in a team environment
• Commitment to maintaining coding accuracy and compliance
• Adaptability to changing coding regulations and client requirements
• Ability to handle confidential patient information in compliance with HIPAA regulations

Preferred Knowledge

• Strong understanding of US Healthcare and Revenue Cycle Management (RCM)
• Familiarity with specialty-specific coding (e.g., Evaluation & Management, Surgery, Radiology, Emergency Medicine, or other specialties)
• Knowledge of payer regulations, coding audits, and reimbursement methodologies
• Experience working with coding quality metrics and internal audits
• Understanding of National Correct Coding Initiative (NCCI) edits and Official Coding Guidelines

Additional Requirements

• Ability to work in a fast-paced, deadline-driven environment
• Willingness to participate in coding audits, continuous learning, and certification renewal activities
• Commitment to maintaining coding quality, productivity, and compliance standards
• Ability to adapt to evolving coding guidelines and healthcare regulations

Job Description

Follow-Up on Claims : Responsible for following up on accounts receivable claims with insurance companies to ensure timely and accurate reimbursement.

Denial Management : Analyze and resolve claim denials and rejections by working with payers to ensure maximum reimbursement.

Documentation & Reporting : Maintain detailed notes of calls and update systems with accurate claim statuses. Generate daily/weekly reports as required.

Insurance Verification : Confirm patient eligibility and insurance coverage details when needed.

Team Coordination : Collaborate with billing teams, supervisors, and clients to resolve complex cases and improve collection processes.

Compliance : Adhere to HIPAA regulations and internal company policies regarding patient information and data security.

Job Description

• Handle patient demographic entry, charge entry, and payment posting.
• Verify insurance details and update records accurately.
• Follow up with insurance companies and patients on pending claims.
• Review and resolve claim rejections or denials.
• Maintain confidentiality and comply with HIPAA regulations.
• Coordinate with team leads and adhere to process timelines.
• Make outbound calls to insurance companies to follow up on pending medical claims.
• Review and analyze outstanding claims and take appropriate actions for resolution.
• Record accurate notes and update claim status in the system.
• Understand denials and escalate unresolved issues to the team lead.
• Ensure adherence to process timelines and quality standards.
• Work in rotational shifts (Day/Night) as per business requirements.

Job Description

• Check the patient’s insurance eligibility and benefits for medical services.
• Contact payers to determine network status of practice and provider.
• Prepare and submit prior authorization (PA) requests to insurance companies.
• Communicate with practice to obtain supporting reports or clinical notes.
• Convey prior authorization status updates to the practice.
• Ensure that all required documentation and clinical information is included.
• Follow up with the payer on the status of the pending authorization requests.
• Obtain the authorization determination information from the payer.
• Resolve denials or incomplete submissions by gathering additional documentation or initiating authorization appeals.
• Accurately log all submitted and received authorizations in the electronic health record (EHR) or in the client tracking system.
• Follow up and maintain update of payer-specific policies / guidelines and prior authorization requirements.
• Help monitor prior authorization request turnaround times to ensure deadlines are met.
• Adhere to HIPAA regulations and internal policies to ensure patient’s privacy.
• Ensure all authorization requests are compliant with payer guidelines and healthcare regulations.
• Participate in staff training in prior authorization related tasks.
• Contribute to process improvement efforts through feedback and suggestions.

Job Description

• Maintain accurate and up-to-date documentation for all payer EDI/ERA/EFT enrollments.
• Communicate promptly with payers, clearinghouses, and internal teams regarding enrollment statuses.
• Identify and resolve any discrepancies or rejections related to submitted applications.
• Provide regular status updates and reports to management or the enrollment lead.
• Stay informed of payer-specific enrollment policy changes and update procedures accordingly.

Job Description

• Handle patient demographic entry, charge entry, and payment posting.
• Verify insurance details and update records accurately.
• Follow up with insurance companies and patients on pending claims.
• Review and resolve claim rejections or denials.
• Maintain confidentiality and comply with HIPAA regulations.
• Coordinate with team leads and adhere to process timelines.
• Make outbound calls to insurance companies to follow up on pending medical claims.
• Review and analyze outstanding claims and take appropriate actions for resolution.
• Record accurate notes and update claim status in the system.
• Understand denials and escalate unresolved issues to the team lead.
• Ensure adherence to process timelines and quality standards.
• Work in rotational shifts (Day/Night) as per business requirements.

Job Description

• Conduct verbal and non-verbal communication training sessions for learners of various levels.
• Design and deliver customized voice and accent training programs in a blended learning environment.
• Continuously update training content to align with new trends and industry best practices.
• Initiate and manage new training programs and modules simultaneously.
• Mentor and guide learners to improve pronunciation, articulation, and overall communication effectiveness.
• Collaborate with team members to enhance training quality and learner engagement.

Job Description

• Manage end-to-end recruitment and onboarding for RCM roles.
• Manage payroll coordination, salary processing support, and statutory compliance.
• Plan workforce requirements and support talent development and performance management.
• Drive employee engagement, retention initiatives, and recognition programs.
• Handle employee relations and grievance management to maintain a positive work environment.
• Ensure compliance with healthcare regulations, labor laws, and company policies.
• Maintain HR documentation, reports, and employee lifecycle processes.
• Collaborate with operations, training, and quality teams to support business objectives.
• Organize internal events and initiatives to strengthen workplace culture.

Key Responsibilities

• Recruitment & Onboarding: Manage end-to-end hiring, candidate onboarding, and employee induction.
• Employee Engagement: Drive engagement initiatives, recognition programs, and employee communication.
• Grievance Handling: Resolve employee concerns and promote a positive work environment.
• Compliance: Ensure adherence to labor laws, statutory requirements, and company HR policies.
• Payroll: Support payroll processing by maintaining attendance, leave, and employee records.
• Event Management: Organize employee engagement activities, celebrations, and awareness programs.
• HR Documentation & Reporting: Maintain HR records, prepare reports, and ensure documentation accuracy.
• Team Collaboration: Partner with cross-functional teams to support HR initiatives and business goals.