Career

Job Title: AR Caller – US Healthcare

Location: Chennai

Experience: 1–5 Years

Shift: Night Shift (US Time Zones)

Job Summary: We are looking for a detail-oriented and proactive AR Caller / Senior AR Caller to join our US Healthcare team. The ideal candidate will be responsible for following up on outstanding insurance claims, ensuring timely payments, and resolving billing issues with insurance companies.

Key Responsibilities:

• Review and analyze unpaid or denied medical claims.

• Follow up with insurance companies via phone or online portals.

• Understand and interpret Explanation of Benefits (EOB), Remittance Advice (RA), and other payer communications.

• Take appropriate action based on claim status: appeal, refile, or escalate as needed.

• Document actions taken in the billing system accurately.

• Meet daily/weekly productivity and quality standards.

• Communicate effectively with team members and escalate complex issues to the supervisor.

Required Skills:

• Strong knowledge of the US healthcare revenue cycle, especially Accounts Receivable.

• Familiarity with insurance guidelines, CPT codes, ICD-10, and HIPAA regulations.

• Excellent communication and negotiation skills.

• Good analytical and problem-solving abilities.

• Proficiency in MS Office and healthcare billing software (e.g., Athena, Epic, or similar platforms).

Job Title: Insurance Verification (IV) Caller – US Healthcare

Location: Chennai

Experience: 1–4 Years

Shift: Night Shift (US Time Zones)

Job Summary:We are seeking a diligent and detail-oriented Insurance Verification (IV) Caller to join our US Healthcare team. The candidate will be responsible for verifying patients' insurance coverage and eligibility by contacting insurance carriers directly, ensuring accurate billing and smooth patient onboarding.

Key Responsibilities:

• Call insurance companies to verify patient eligibility, benefits, coverage details, and authorization requirements.

• Accurately document verification details such as co-pays, deductibles, co-insurance, plan exclusions, and policy limitations.

• Coordinate with providers, billing teams, and patients to ensure insurance information is complete and up-to-date.

• Update patient records with verified insurance data in the system.

• Meet daily targets for verification volume and quality.

• Maintain compliance with HIPAA and company policies at all times.

Required Skills:

• Basic understanding of the US healthcare system and insurance verification process.

• Strong verbal communication and listening skills.

• Attention to detail and ability to follow protocols accurately.

• Comfortable working night shifts aligned to US time zones.

• Experience with EHR/EMR systems and payer portals is an advantage.

Job Title: Credit Balance Specialist – US Healthcare RCM

Location: Chennai

Experience: 1–4 Years

Shift: Night Shift (US Time Zones)

Job Summary: We are seeking a skilled Credit Balance Specialist to manage and resolve credit balances and overpayments in the US Healthcare Revenue Cycle Management (RCM) process. The ideal candidate should have strong analytical skills and a good understanding of payer rules and billing practices to ensure accurate resolution of patient and payer credits.

Key Responsibilities:

• Analyze patient and payer accounts with credit balances.

• Investigate and resolve overpayments, duplicate payments, and incorrect postings.

• Initiate refund requests or adjustments as per company policy and payer guidelines.

• Coordinate with billing, AR, and payment posting teams to ensure accurate resolution.

• Respond to refund audits and payer requests for documentation.

• Maintain detailed and accurate account notes and audit trails.

• Ensure compliance with HIPAA and RCM best practices.

Required Skills:

• Strong understanding of US healthcare RCM, especially credit balance and refund processes.

• Knowledge of payer regulations, billing guidelines, and healthcare terminology.

• Familiarity with EOBs, remittance advice, and denial codes.

• Excellent analytical and problem-solving skills.

• Experience working with billing software (e.g., Epic).

• Good communication and documentation skills.

Job Summary: We are looking for a dynamic and result-driven Business Development Executive with experience in the US Healthcare industry. The ideal candidate will be responsible for identifying new business opportunities, building strong client relationships, and driving revenue growth through strategic outreach and engagement with healthcare providers and organizations in the US market.

Key Responsibilities:

• Identify and target potential clients in the US healthcare sector (providers, billing companies, RCM firms, etc.).

• Generate leads through cold calling, email campaigns, LinkedIn outreach, and networking.

• Set up meetings and presentations with key decision-makers.

• Understand client requirements and pitch appropriate healthcare BPO/RCM solutions.

• Prepare proposals, quotations, and business contracts in collaboration with internal teams.

• Maintain and update CRM tools with accurate and timely data.

• Meet or exceed monthly and quarterly sales targets.

• Collaborate with the marketing team to align lead-generation strategies.

Required Skills:

• Solid understanding of US Healthcare processes such as RCM, medical billing, AR calling, etc.

• Proven experience in lead generation, sales, or business development.

• Excellent communication and interpersonal skills.

• Strong negotiation and closing skills.

• Ability to work independently and manage time effectively.

• Familiarity with CRM software (e.g., Salesforce, HubSpot) is a plus.

Job Title: Medical Coder – Multispecialty Denials (Radiology & Pathology)

Location: Chennai

Experience: Minimum 1 Year

Shift: Day Shift

Job Summary: We are seeking an experienced Medical Coder specializing in denials management for Radiology and Pathology to join our RCM team. The ideal candidate will be responsible for analyzing denied claims, identifying root causes, and accurately re-coding or appealing based on payer guidelines.

Key Responsibilities:

• Review and analyze denied claims specifically in Radiology and Pathology specialties.

• Identify coding-related denial reasons and rework claims accordingly.

• Apply accurate CPT, ICD-10, and HCPCS codes based on medical documentation.

• Prepare and submit coding appeals with appropriate justifications and references.

• Collaborate with AR and billing teams for resolution of complex denials.

• Ensure adherence to compliance standards and payer-specific guidelines.

• Maintain productivity and quality benchmarks as per company standards.

Required Skills:

• Strong knowledge of Radiology and Pathology coding.

• Experience handling denials and appeals in a US Healthcare RCM environment.

• Proficiency with coding tools and systems (e.g., EncoderPro, Optum360, or similar).

• Familiarity with payer-specific policies and LCD/NCD guidelines.

• Strong analytical, written, and verbal communication skills.

Job Title: Medical Coder – Multispecialty Denials (E/M)

Location: Chennai

Experience: Minimum 1 Year

Shift: Day Shift

Job Summary: We are looking for an experienced Medical Coder with expertise in Evaluation and Management (E/M) coding to handle multispecialty denial resolutions. The ideal candidate will be responsible for reviewing denied E/M claims, identifying root causes, and ensuring accurate recoding or appeal submission in accordance with payer policies.

Key Responsibilities:

• Review and rework denied claims related to E/M services across various specialties.

• Analyze medical records and documentation to assign accurate CPT, ICD-10, and HCPCS codes.

• Identify reasons for denials such as level-of-service issues, lack of documentation, or bundling edits.

• Draft and submit appeals with clinical justification based on payer-specific guidelines.

• Coordinate with AR and billing teams to ensure timely claim resolution.

• Maintain high accuracy and compliance with CMS, payer, and internal guidelines.

• Meet productivity and quality targets as defined by management.

Required Skills:

• Proficient in E/M coding and documentation guidelines (2021+ updates).

• Strong understanding of multispecialty billing and denial patterns.

• Experience working with coding software and EMR/EHR platforms.

• Familiarity with payer rules, including Medicare and commercial insurers.

• Excellent attention to detail, communication, and analytical skills.

Job Title: Medical Coder – E/M Coding

Location: Chennai

Experience: Minimum 1 Year

Shift: Day Shift

Job Summary: We are looking for a skilled and detail-oriented E/M Medical Coder to join our medical coding team. The ideal candidate will have a solid understanding of Evaluation and Management (E/M) coding guidelines, with experience in assigning accurate CPT, ICD-10, and HCPCS codes for various clinical encounters across multiple specialties.

Key Responsibilities:

• Review clinical documentation and assign appropriate E/M CPT codes based on 2021+ AMA guidelines.

• Accurately assign ICD-10-CM diagnosis codes and any applicable HCPCS codes.

• Ensure coding compliance with CMS, payer-specific, and internal standards.

• Collaborate with providers and documentation teams to clarify discrepancies or missing information.

• Maintain productivity and accuracy targets as per company standards.

• Keep up to date with changes in coding regulations and payer guidelines.

Required Skills:

• Strong knowledge of E/M coding guidelines (pre- and post-2021 updates).

• Familiarity with specialties such as Internal Medicine, Family Medicine, Cardiology, Urgent Care, etc.

• Working knowledge of coding software tools and EHR/EMR platforms.

• Attention to detail and strong analytical and communication skills.

Location: Chennai

Experience: Minimum 1 Year

Shift: Day Shift

Job Summary: We are seeking an experienced Inpatient DRG Coder with strong expertise in ICD-10-CM and PCS coding for hospital inpatient services. The role involves accurate assignment of MS-DRGs or APR-DRGs based on thorough documentation review and coding guidelines.

Key Responsibilities:

• Review inpatient charts and assign ICD-10-CM and ICD-10-PCS codes accurately.

• Determine appropriate MS-DRG/APR-DRG based on coding rules and grouping logic.

• Ensure coding compliance with CMS, AHA Coding Clinic, and hospital guidelines.

• Query physicians when documentation is insufficient or ambiguous.

• Meet or exceed accuracy and productivity benchmarks.

• Keep up-to-date with DRG updates and regulatory changes.

Qualifications:

• Certified Coding Specialist (CCS) or equivalent required.

• Minimum 1 year of IPDRG coding experience.

Location: Chennai

Experience: Minimum 1 Year

Shift: Day Shift

Job Summary: We are hiring a Surgery Coder proficient in assigning accurate CPT, ICD-10-CM, and HCPCS codes for various surgical specialties such as general surgery, orthopedics, gastroenterology, and cardiology.

Key Responsibilities:

• Review operative reports and assign accurate surgical CPT, ICD-10-CM, and HCPCS codes.

• Ensure coding meets documentation standards and payer-specific rules.

• Collaborate with providers to clarify documentation issues as needed.

• Maintain coding accuracy and productivity targets.

• Keep current with surgical coding guidelines and specialty-specific updates.

Qualifications:

• CPC, COC, or CCS certification required.

• Minimum 1 year of experience in surgery coding.

• Strong knowledge of modifiers, global periods, and bundling rules.

Location: Chennai

Experience: Minimum 4-8 Year

Shift: Day Shift

Job Summary: We are seeking a Surgery Coding Auditor to perform quality assurance reviews and ensure compliance with surgical coding standards across various specialties. The ideal candidate should have deep knowledge of surgical procedures and coding policies.

Key Responsibilities:

• Audit surgical coding for accuracy, completeness, and compliance.

• Provide feedback to coders and conduct training sessions based on audit findings.

• Identify trends in errors and recommend corrective actions.

• Prepare audit reports and maintain audit documentation.

• Collaborate with QA, compliance, and training teams.

Qualifications:

• Certified Coding Auditor (CPC-A, CPMA, or CCS-P) preferred.

• 3+ years of experience in surgical coding and auditing.

• Expertise in multiple surgical specialties and coding regulations.

Location: Chennai

Experience: Minimum 4-8 Year

Shift: Day Shift

Job Summary: We are looking for a Denial Coding Auditor to analyze coding-related denials, identify root causes, and recommend resolutions. The role involves working closely with AR, coding, and compliance teams to improve first-pass resolution rates.

Key Responsibilities:

• Review denied claims and audit coding accuracy and documentation.

• Identify denial trends (e.g., medical necessity, bundling, modifier usage).

• Recommend coding corrections and documentation improvements.

• Coordinate with AR and appeal teams for denial resolution.

• Support internal audits and compliance reviews.

Qualifications:

• Certified Coding Auditor (CPC-A, CPMA, or CCS-P) preferred.

• 3+ years of experience in surgical coding and auditing.

• Expertise in multiple surgical specialties and coding regulations.

We’re always eager to connect with talented individuals. If you’re interested in joining our team, please send your resume to recruitment@qwayhealthcare.com and follow us on LinkedIn to stay updated on opportunities.