Medical Billing Specialist

Department: Client Solutions

Work Schedule: IST with EST overlap as required

We are seeking a detail-oriented and experienced Medical Billing Specialist to support our Remote Patient Monitoring (RPM) and Chronic Care Management (CCM) operations. You will be responsible for managing the end-to-end billing lifecycle for our US-based healthcare providers. This includes both supporting and/or executing claim submission, denial management, and ensuring compliance with the latest billing regulations. The ideal candidate has a deep understanding of US insurance payers (Medicare/Private) and the nuances of time-based remote care billing.

• Claim Management: Prepare, review, and submit electronic insurance claims for RPM services (Ex. CPT codes 99453, 99454, 99457, and 99458).
• Provider Support: In some instances, log directly into client EHR/Billing systems to submit claims on their behalf with 100% accuracy.
• Denial & Appeals: Identify reasons for claim denials, conduct research, and submit corrected claims or appeals to ensure maximum reimbursement.
• Payment Posting: Accurately post payments and adjustments from EOBs (Explanation of Benefits) and ERAs.
• Compliance: Maintain strict adherence to HIPAA regulations and ensure all billing practices meet US federal and state guidelines.
• A/R Follow-up: Proactively monitor aging reports and follow up with payers on outstanding claims.
• Best Practices: Stay updated on changing RPM billing codes and documentation requirements to advise the internal team on process improvements.

Experience

3+ years in US Medical Billing (RCM), with at least 1 year focused on RPM or Chronic Care Management (CCM).

Technical Skills

Proficiency in major EHR/PM systems (e.g., eClinicalWorks, Athenahealth, AdvancedMD, or Kareo).

Knowledge

Expert-level understanding of Medicare guidelines, CPT/ICD-10 coding, and the "30-day" billing cycle for RPM.

Communication

Excellent written and verbal English skills (as you will be interacting with US-based teams and potentially payers).

Infrastructure

High-speed, stable internet connection and a secure, private workspace (compliant with data security standards).

• Certified Professional Coder (CPC) or Certified Professional Biller (CPB) through AAPC.
• Experience working in a fast-paced healthcare technology company.
• Advanced Excel skills for data reporting and reconciliation.

Note on Data Security: As this role involves handling Protected Health Information (PHI) from India, the candidate must demonstrate a high level of security awareness and may be required to work via a secure VPN or company-provided hardware.