Medical Claims Analyst – Med-Metrix
Location: Chennai, Tamil Nadu, India
Job Type: Full-Time
Experience Required: Minimum 1 Year (Healthcare A/R, Medical Billing, Denials, Appeals)
Job Overview
Med-Metrix is seeking a skilled Medical Claims Analyst to manage collections, billing operations, account follow-up, and payment posting for assigned healthcare accounts. The role requires strong analytical skills, knowledge of payer guidelines, and the ability to resolve claim issues efficiently within established timelines.
This position is suited for professionals with hands-on experience in Healthcare Accounts Receivable (A/R), medical billing processes, claim status verification, and payer communication.
Key Responsibilities
Conduct timely follow-up with payers via phone, email, fax, or online portals to resolve outstanding claims.
Meet and maintain productivity and quality targets as defined by departmental policies.
Use workflow management systems and client-host applications to collect payments and work accounts effectively.
Adhere to all client-specific and internal operational procedures.
Maintain up-to-date knowledge of payer-specific timely filing requirements.
Research payer billing guidelines and apply appropriate solutions to claim issues.
Analyze and resolve delays in payments, including identifying trends to prevent future denials.
Escalate identified patterns or issues to management for proactive action.
Initiate appeals when necessary and prepare accurate supporting documentation.
Identify and correct billing errors to reduce financial losses.
Understand underpayment, overpayment, and credit balance procedures.
Support special A/R projects requiring analytical insights and reporting.
Maintain a professional, confidential, and customer-focused demeanor.
Independently manage assigned work queues.
Ensure full compliance with HIPAA and Information Security standards.
Limit access to Protected Health Information (PHI) based strictly on job necessity.
Perform additional duties as required by the management team.
Required Qualifications
Completed High School education or higher.
Minimum 1 year of experience in Healthcare A/R, collections, medical billing, payer calling, claims processing, denials, and appeals within a BPO or healthcare operations environment.
Hands-on experience with:
Claim status verification
A/R follow-ups
Payment disputes
Medical billing systems
Strong interpersonal communication abilities across all organizational levels.
Proven analytical and problem-solving skills with sound judgment.
Strong written and verbal communication skills.
Ability to maintain professionalism in customer interactions.
High integrity, dependability, and a results-driven mindset.
Working Conditions
Willingness to work night shifts as per business requirements.
Occasional physical activity including movement around the workspace and use of office equipment.
Ability to handle stress, follow directions, and collaborate effectively.
Work environment offers minimal noise levels and standard operational settings.
Equal Opportunity Statement
Med-Metrix is committed to an inclusive employment environment and does not discriminate based on race, color, religion, sex, pregnancy, gender identity, sexual orientation, parental status, national origin, age, disability, genetic information, political affiliation, military service, veteran status, or any characteristic protected by law.
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