Walk-in || Process Associate For Denial Management (Non-Voice)

Job Summary

We are looking for detail-oriented and analytical professionals to join our Revenue Cycle Management (RCM) team as Process Associates Denial Management. The ideal candidate will be responsible for analyzing insurance claim denials, identifying denial reasons, performing necessary claim corrections, and supporting timely reimbursement through non-voice operations.

Roles and Responsibilities

• Analyze denied medical claims and identify the reasons for denial.
• Review Explanation of Benefits (EOBs), Electronic Remittance Advice (ERA), and claim-related documents.
• Investigate denial reasons such as authorization issues, eligibility errors, coding errors, timely filing, and medical necessity.
• Perform claim corrections, updates, and resubmissions based on payer guidelines.
• Prepare and submit appeals with appropriate supporting documentation wherever applicable.
• Work on assigned accounts through billing software, payer portals, and internal systems.
• Maintain accurate documentation and update denial status in the system.
• Follow up on pending denials through non-voice channels, including payer portals and written correspondence, as applicable.
• Identify recurring denial trends and escalate complex cases to the appropriate team.
• Meet daily productivity, quality, and turnaround time (TAT) targets.
• Ensure compliance with client requirements, company policies, and HIPAA guidelines.
• Coordinate with internal teams to resolve claim discrepancies and reduce revenue leakage.

Required Skills and Qualifications

• Any graduate; candidates with relevant healthcare or medical billing qualifications are preferred.
• Basic knowledge of US healthcare RCM and medical billing is an advantage.
• Understanding of medical claims, insurance denials, EOBs, and AR follow-up is preferred.
• Good analytical, problem-solving, and documentation skills.
• Strong attention to detail and ability to work with data.
• Basic computer knowledge and proficiency in MS Excel.
• Good written communication skills.
• Ability to meet productivity and quality targets in a deadline-driven environment.
• Willingness to work night shifts.

Preferred Experience

• Experience in US healthcare RCM, medical billing, or denial management is an added advantage.
• Familiarity with payer portals, denial codes, claim corrections, and appeals is preferred.
• Candidates with non-voice healthcare process experience will be given preference.