Billing Executive

Job Summary:

The Billing Executive is responsible for accurate medical billing, timely submission and follow up of insurance claims, handling appeals for denied claims, and auditing patient accounts to ensure compliance, accuracy, and optimal reimbursement. Key Responsibilities • Prepare, review, and submit medical bills and insurance claims accurately and within defined timelines. • Monitor claim status and follow up with insurance companies to ensure timely reimbursement. • Analyze denied or underpaid claims and identify root causes. • Prepare and submit appeal letters with supporting clinical and billing documentation. • Coordinate with medical records, coding, and clinical teams to resolve denial issues. • Track appeal outcomes and update systems accordingly. • Audit patient accounts to verify accuracy of charges, payments, adjustments, and balances. • Identify billing discrepancies, revenue leakage, and compliance risks. • Ensure adherence to payer contracts, regulatory guidelines, and internal policies. • Recommend corrective actions based on audit findings. • Communicate with insurance companies, TPAs, and payers regarding claims, appeals, and payment discrepancies. • Verify insurance coverage, benefits, and authorization details when required. • Post payments, adjustments, and write-offs accurately. • Prepare aging, denial, and audit reports for management review. • Support month-end and audit closure activities. • Assist in improving billing, audit, and appeal processes to maximize revenue and reduce denials.

Required Qualifications: • Bachelor’s degree in commerce, Accounting, Healthcare Administration, or related field • 2–5 years of experience in medical billing, claims processing, and appeals. (Freshers also welcome)