Virendra Singh

Senior Account Receivable Specialist @Exprimunt Medical Billing Pvt Ltd

Jaipur, IN

Key Responsibilities:1. Claim Follow-upTrack unpaid or underpaid insurance claims.Contact insurance companies via phone, email, or portal for claim status.Follow up regularly based on payer-specific timeframes.2. Denial ManagementAnalyze denied claims and determine reasons for rejection.Take corrective actions like correcting codes, attaching documents, or resubmitting claims.Work with the coding and charge entry teams if needed.3. Payment Posting ReviewEnsure payments are correctly posted by the payment posting team.Identify discrepancies between billed amounts and paid amounts.4. Verify patient insurance eligibility and benefits.Ensure prior authorization is obtained when required.5. Appeals and Re-submissionsPrepare and submit appeals for denied or underpaid claims.Track the appeal process and ensure resolution.Explain outstanding balances and offer payment options.6.Documentation and ReportingMaintain accurate records of all communications and actions taken.Generate AR aging reports (e.g, 30, 60, 90+ days outstanding).Report trends in denials and delays to the management team.7. ComplianceEnsure adherence to HIPAA regulations and payer-specific guidelines.Stay updated with insurance and billing rules (e.g, Medicare, Medicaid, private insurers).Strong communication (especially with insurance companies)Knowledge of CPT, ICD-10, and HCPCS codingFamiliarity with EHR and billing softwareAnalytical skills for denial and payment analysisTime management and follow-up discipline