AR CALLING - INTERNATIONAL PROCESS

Company Description FiveS Digital is a technology-led Business Process Management organization with a strong customer- and community-centric focus. For over 15 years, the company has delivered solutions in customer experience, digital transformation, and data annotation across 9 locations in India, including a diverse and inclusive BPM delivery center in Navi Mumbai. With a team of over 3,500 professionals, FiveS Digital supports multiple industries such as e-commerce/retail, healthcare, BFSI, and logistics. The organization is certified as a women-owned diversity unit by WeConnect International, USA, and is committed to diversity, equity, and inclusion as it continues to grow.
Role Description The Medical Billing Specialist is a full-time, on-site role based in Bengaluru. This role involves preparing, submitting, and tracking medical claims to insurance providers, including Medicare and private insurers, ensuring accuracy in coding and patient information. The specialist will review and interpret medical records, apply ICD-10 codes, manage claim denials, and follow up on outstanding balances to support timely reimbursement. Daily tasks include verifying insurance coverage, updating billing systems, maintaining detailed documentation, and collaborating with clinical and operations teams to resolve billing issues. The role also requires adherence to compliance standards, confidentiality guidelines, and internal quality processes.
Qualifications

• Knowledge of medical terminology and the ability to interpret clinical documentation for billing purposes.
• Proficiency in ICD-10 coding and familiarity with standard medical billing and coding practices.
• Experience handling insurance claims, including private insurers and Medicare, and understanding of payer guidelines.
• Skill in managing and resolving denials, including root-cause identification and resubmission of corrected claims.
• Strong attention to detail, numerical accuracy, and ability to work with billing software and electronic health records.
• Effective written and verbal communication skills, with the ability to collaborate with internal teams and external payers.
• Ability to work on-site in Bengaluru, manage time efficiently, and maintain confidentiality of patient and business information.
• Preferred: Prior experience in medical billing or revenue cycle management, and a diploma/degree in healthcare, finance, or a related field.