Billing Rejection Specialist

• Review and manage clearinghouse portals daily to capture, sort, and action front-end rejections
• Contact insurance companies via phone or web portals to investigate complex claim rejections, verify active patient eligibility, and check benefit coverage details
• Investigate root causes of claim rejections, including demographic errors, missing insurance details, coding discrepancies, and provider credentialing mismatches
• Update and correct patient demographics, insurance policy numbers, CPT/ICD-10 codes, and modifiers in practice management or EHR software before resubmitting claims
• Partner with internal staff and medical coders to address data capture errors and help prevent recurring rejections
• Maintain accurate logs of rejected claims, rejection trends, and resolution turnaround times, providing visibility to billing management

• 1 to 3 years of professional experience in medical billing, revenue cycle operations, or high-volume healthcare administration
• Hands-on familiarity with major clearinghouses and electronic health record (EHR) / practice management software, including Waystar, Cortex, Epic, Athenahealth, eClinicalWorks, or NextGen
• Exceptional attention to detail with strong alphanumeric data entry and verification skills
• Solid foundational understanding of medical terminology, health insurance structures (Medicare, Medicaid, Commercial), and CMS-1500 claim formats
• Strong telephone etiquette and interpersonal communication skills for payer outreach
• Analytical capability to diagnose billing errors independently
• Proven ability and commitment to reliably work the 6:00 PM to 3:00 AM IST night shift schedule
• High school diploma or equivalent required
• Associate's degree or general background in healthcare administration or medical billing preferred