Website:
sprocketinternational.com
Job details:
About the Role
We are looking for an AR Adjustment Assistant to manually process complex claim adjustments in Modernizing Medicine (ModMed) for US-based podiatry and orthopedic surgery practices. This role focuses on applying specific adjustment codes, referencing fee schedules (system and Medicare), and executing multi-step adjustment workflows to bring claims to correct balances. This is an onsite role based in Bangalore, India, requiring US business hours.
Key Responsibilities
- Process contractual adjustments in ModMed to reduce gross charges to the allowable amount based on system or Medicare fee schedules
- - Apply secondary adjustments to zero out remaining claim balances for specific scenarios (e.g., no-authorization, untimely follow-up, write-offs)
- - Reference and apply correct adjustment codes according to payer contracts and internal guidelines
- - Cross-reference fee schedules (system-based and Medicare) to determine correct allowable amounts before processing adjustments
- - Work through assigned adjustment queues and worklists with accuracy and within turnaround targets
- - Identify and flag discrepancies between expected and actual allowable amounts for supervisor review
- - Maintain detailed records of adjustments processed, including codes applied and rationale
- - Communicate with the billing and AR team to resolve accounts requiring additional context or escalation
- - Ensure compliance with HIPAA and payer-specific billing regulations
Requirements
- 1+ year of experience in medical billing, payment posting, or accounts receivable in a US healthcare setting
- - Hands-on experience with Modernizing Medicine (ModMed / EMA) - required
- - Understanding of contractual adjustments, write-offs, and how allowable amounts are determined from fee schedules
- - Familiarity with Medicare fee schedules and commercial payer reimbursement structures
- - Working knowledge of common adjustment and denial reason codes
- - Strong attention to detail and ability to process high volumes of adjustments accurately
- - Proficient in Excel and data entry
- - Strong written English communication skills
- - Available to work US business hours (EST/CST) onsite in Bangalore
Preferred
- Experience with podiatry, orthopedic surgery, or surgical specialty billing
- - Experience working in an offshore BPO environment supporting US healthcare clients
- - Familiarity with EOB/ERA reconciliation and payment posting workflows
- - AAPC certification: Certified Professional Biller (CPB) or equivalent
Core Competencies
- High accuracy and consistency in repetitive, detail-oriented tasks
- - Ability to follow documented procedures and apply rules-based logic to claim adjustments
- - Strong time management and ability to work through high-volume queues independently
- - Proficient touch-typing skills
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