Key Responsibilities:

- Provide subject matter expertise in the complete medical billing lifecycle.
- Review and process medical claims accurately and within TAT.
- Analyze and resolve claim denials, rejections, and payment variances.
- Perform Accounts Receivable (AR) follow-up and appeals with insurance payers.
- Ensure compliance with HIPAA, payer guidelines, and client-specific processes.
- Conduct quality audits and provide feedback to improve team performance.
- Mentor, train, and support team members on RCM processes and updates.
- Handle client escalations and provide timely resolutions.
- Prepare daily, weekly, and monthly productivity and quality reports.
- Identify process improvement opportunities to increase collections and reduce denials.
- Collaborate with cross-functional teams to achieve operational and financial goals.




- Required Skills:

- Solid knowledge of US Healthcare Revenue Cycle Management (RCM).
- Expertise in Medical Billing, AR Follow-up, Denial Management, Appeals, Payment Posting, and Claims Processing.
- Understanding of ICD-10, CPT, and HCPCS coding concepts.
- Familiarity with EHR/EMR systems such as Epic, Athena, Kareo, eClinicalWorks, or similar platforms. Preferably NextGen Experience
- Knowledge of Medicare, Medicaid, and commercial insurance guidelines.
- Excellent analytical, communication, and problem-solving skills.
- Strong leadership, coaching, and stakeholder management abilities.

📌 Medical Billing Subject Matter Expert (Hyderabad)
🏢 Credense Medical Billing
📍 Hyderabad