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.
Solid leadership, coaching, and stakeholder management abilities.

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