Medical Billing Specialist

Job Description

Job Summary: We are seeking an experienced Medical Billing Manager to oversee and streamline our billing operations. The ideal candidate will have a strong background in medical billing processes, insurance claim management, team supervision, and revenue cycle optimization. The role involves ensuring accurate billing, timely reimbursements, compliance with industry regulations, and leading a team of billing specialists. Key Responsibilities: Supervise and manage the medical billing team to ensure accurate and timely claim submissions. Monitor and resolve denied or rejected claims, ensuring prompt follow-ups with insurance providers. Maintain compliance with HIPAA, payer-specific rules, and federal/state healthcare regulations. Oversee daily billing operations including coding validation, charge entry, claim submission, payment posting, and account reconciliation. Generate and analyze billing reports to monitor KPIs such as DSO (Days Sales Outstanding), claim denial rates, and collection percentages. Work closely with coding, collections, and clinical departments to resolve billing-related issues. Train and evaluate billing staff, provide guidance, and implement performance improvement plans when needed. Develop, document, and update billing policies and standard operating procedures. Ensure timely communication with patients and clients regarding billing inquiries or disputes. Coordinate audits (internal and external) and ensure documentation accuracy and readiness. Manage software systems related to billing (e.g., Kareo, Athenahealth, NextGen, etc.) Requirements: Bachelor’s degree in Healthcare Administration, Finance, Accounting, or a related field. Minimum 5 years of experience in medical billing, with at least 2 years in a managerial role. Proficiency with electronic medical records (EMRs) and billing software. Strong knowledge of CPT, ICD-10, and HCPCS coding systems. Excellent leadership, organizational, and analytical skills. Effective communication and problem-solving abilities. Knowledge of payer-specific guidelines including Medicare, Medicaid, and private insurance. Certification in Medical Billing/Coding or RCM (e.g., CPC, CPB, CMRS) preferred. Preferred Skills: Experience in multi-specialty or hospital-based billing. Familiarity with AR analysis and revenue cycle analytics tools. Hands-on experience with denial management strategies. Job Types: Full-time, Permanent, Fresher Pay: ₹30,000.00 - ₹60,000.00 per month Benefits: Health insurance Life insurance Provident Fund Schedule: Monday to Friday Night shift US shift Work Location: In person