JOB OVERVIEW

Cube Healthcare Systems is a subsidiary of the Healthcare Technology Company based in Michigan, USA providing healthcare solutions to the clients in the US. Presently, Cube Healthcare Systems is the largest company at KPIT board, with fast growing healthcare IT services and product base.

As a healthcare solution provider, CHS is successfully carrying out revenue management services for its clients based in the USA.

Our product: ALTUMED, a Revenue Cycle Management Software takes Medical Billing to another degree of automation and advancement. In Pakistan, with the main Office in Abbottabad, business teams are pro-actively making client experience and business a success.

Role overview

This position involves handling various aspects of the revenue cycle, including claims processing, payment posting, and denial management. The Medical Billing Specialist ensures that healthcare services are billed accurately and efficiently, payments are properly recorded, and any issues related to claims and reimbursements are addressed promptly.

RESPONSIBILITIES

• Claims Processing: Prepare, submit, and manage medical claims to insurance companies, ensuring accuracy and compliance with payer guidelines and healthcare regulations.
• Payment Posting: Accurately post payments and adjustments received from insurance companies and patients to patient accounts and reconcile discrepancies.
• Denial Management: Analyze and resolve claim denials by reviewing denial codes, preparing appeals, and resubmitting corrected claims. Track denial trends and implement process improvements.
• Coding Review: Verify and ensure that medical coding (ICD-10, CPT, HCPCS) is accurate and reflects the services provided, collaborating with coders as needed.
• Patient Billing: Generate and send patient statements, manage patient account balances, and address patient inquiries regarding billing and payments.
• Compliance: Ensure that billing practices comply with federal, state, and payer-specific regulations, including HIPAA and other privacy standards.
• Reporting: Generate and analyze billing reports, including payment activity, accounts receivable aging, and claim status. Provide insights to improve revenue cycle performance.
• Customer Service: Provide excellent service to healthcare providers, patients, and insurance companies. Resolve billing issues, answer questions, and maintain positive relationships.
• Documentation: Maintain accurate records of billing activities, payments, and communications. Ensure documentation is organized and accessible for audits and reviews.

QUALIFICATIONS

• Technical Skills: Proficiency in medical billing software, electronic health record (EHR) systems, and Microsoft Office Suite (Excel, Word).
• Experience: Minimum of 3 years of experience in medical billing, coding, or revenue cycle management.
• Knowledge: Strong understanding of medical coding, billing processes, insurance policies, and healthcare regulations.
• Skills: Excellent analytical, problem-solving, and organizational skills. Strong attention to detail and ability to manage multiple tasks simultaneously.
• Communication: Effective written and verbal communication skills, with the ability to interact professionally with patients, healthcare providers, and insurance representatives.

KEY PERFORMANCE INDICATORS

• Claim Accuracy Rate
• Claims Denial Rate
• Denial Resolution Rate
• Days in Accounts Receivable (AR)
• Payment Posting Accuracy Rate
• Patient Statement Error Rate
• Appeal Submission Time
• Collection Rate
• Revenue Cycle Time
• Customer Service Satisfaction

bENEFITS

Market-Leading Salary, Medical insurance, Provident fund, EOBI, Paid Leaves, cash advance, Employee Performance based bonuses, Annual increments, Allowances ( Accommodation, OPD, Travel, Night, utilities, Technical ), Parental Leaves, Annual dinners & trips

Note: Preference will be given to candidates from Hazara Division, KPK for this specific role. However, candidates from all over the Pakistan are welcomed.

For more information, please visit:

www.cubehcs.com

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