Altos is seeking a knowledgeable, experienced, and motivated Subject Matter Expert (Medical Billing) to join our growing team. SME will be responsible for supporting billing operations, assisting the team leads in managing assigned client processes, ensuring timely and accurate claim submission, analyzing billing trends, and assisting the team with complex billing-related issues & Queries.

The ideal candidate should have strong experience in US Healthcare Revenue Cycle Management (RCM), excellent knowledge of medical billing processes, and the ability to work closely with Billing Team Leads and Operations Managers to ensure operational efficiency and timely resolution of billing issues.

Roles and Responsibilities

- Take complete ownership of assigned small clients for billing processes.
- Prepare and analyze billing trends for each assigned client.
- Provide support and assistance to Team Leads and the Billing Manager in resolving billing-related issues, addressing process challenges, and ensuring timely completion of billing activities.
- Communicate all process and client-related changes to direct reports within defined timelines and maintain proper records of such updates.
- Handle billing-related queries and ensure timely resolution.
- Ensure that billing is processed accurately and within the required timelines.
- Should be well-trained in handling claim rejections, identifying the root causes, taking appropriate corrective action, and implementing preventive measures to avoid similar rejections in the future.
- Meet daily, weekly, and monthly individual performance targets.
- Support and assist with payer enrollment activities for various insurance payers.




- Review billing processes and identify opportunities for improvement and increased efficiency.
- Provide process-related guidance and support to billing team members when required.
- Identify billing issues, delays, and process gaps and escalate them to the appropriate management team.
- Work closely with the Billing Team Lead and Operations Manager to discuss billing-related issues, process challenges, and delays.
- Support the team in ensuring timely completion of billing tasks and adherence to client-specific requirements.
- Participate in client meetings, understand client requirements, and support the team in implementing process changes.
- Ensure compliance with applicable company policies, client requirements, HIPAA regulations, and established billing procedures.

Job Requirements
- Must have at least 4 years of experience working in RCM processes (professional billing) in the profile of a Billing Executive or a similar role.
- 1 year plus experience as a SME

- Strong working knowledge of

- Commercial insurance

- Medicare

- Managed Care
- Having workers' comp knowledge will be preferred
- Having good knowledge of Medisoft software
- Must be a Graduate in any stream.
- Must be well-versed in medical billing terminology and processes.
- Excellent communication, presentation, and interpersonal skills.
- Excellent time management and organizational skills.
- Proficiency in Microsoft Office applications, including Excel, Word, and PowerPoint.
- Must have knowledge of HIPAA regulations and understand their significance in the US Healthcare RCM process.
- Strong analytical and problem-solving skills.
- Robust attention to detail and commitment to accuracy.
- Ability to work independently as well as collaboratively with team members and management.

📌 Subject Matter Expert-Billing (Noida)
🏢 Altos
📍 Noida