Job Description

About the RoleAs a Senior Customer Support Associate - US Healthcare Billing & Claims, you will serve as the primary point of contact for hospitals and clients, managing claims, payments, coding, and billing inquiries. The role demands a balance of technical billing expertise, analytical problem-solving, and excellent communication skills to ensure accurate and timely resolution of client issues.Required Candidate Profile:- Experience: Minimum 2 years as a Support Agent in Medical Billing within an international BPO or Customer Service setup (Voice).- Communication: Excellent spoken and written English; professional and clear communication.- Flexibility: Willingness to work in rotational shifts and rotational week offs.- Work Mode: Work From Office (WFO).- Joining: Immediate joiners preferred.Key Responsibilities- Assist hospital billing staff and clients in resolving issues with claims, payments, coding, and reports via calls, email, or ticketing systems.- Guide the preparation and submission of CMS-1500 and UB-04 claims; validate billing data to prevent rejections.- Investigate claim rejections and denials, recommend corrections for coding errors, missing modifiers, or authorization mismatches.- Support ERA/EOB interpretation, payment posting, underpayment follow-ups, denials, and payer appeals.- Ensure compliance with CPT/HCPCS/ICD-10 codes and payer-specific billing rules.- Analyze aging reports, denial trends, and create SOPs for recurring issues.- Maintain HIPAA compliance in all client interactions and protect sensitive data.- Independently analyze and resolve customer queries, acting as the first point of contact.- Escalate issues appropriately and maintain SLA adherence with accuracy and timeliness.- Address process-related queries, customer grievances, and complex billing cases.- Uphold ethical conduct, workplace professionalism, and respectful collaboration with colleagues.Skills & Competencies- Strong verbal and written communication skills, suitable for US clients.- Excellent medical billing knowledge and analytical/problem-solving skills.- Detail-oriented with ability to provide accurate, timely resolutions.- Customer-first attitude with commitment to service excellence.- Ability to manage time efficiently and adapt to changing business requirements. (ref:updazz.com)

Skills Required