Job Title: Billing Subject Matter Expert (SME) – Remote
Location: India (Remote)
Employment Type: Full-Time, Permanent
Experience Required: 3–6 years in healthcare billing, claims management, or revenue cycle management
Zealie is a rapidly growing Medical Billing Services company specializing in the Behavioral Healthcare industry, serving clients in substance use disorder treatment, addiction recovery, and mental health treatment centers. Our proprietary technology provides advanced data analytics and revenue prediction tools to help healthcare organizations optimize operations and achieve sustainable growth.
We are committed to delivering high-quality services and recognize the pivotal role of our Billing and Utilization Review teams in maintaining accuracy, compliance, and efficiency across the revenue cycle.
The Billing Subject Matter Expert (SME) is a key role within the Revenue Cycle Management (RCM) team. The SME ensures accurate and efficient billing processes, handles escalated claims, and implements payer-specific rules, including VA and Tricare requirements. This role requires strong analytical skills, attention to detail, and proficiency in billing software to support billing accuracy and optimize claim submission practices.
Escalated Claims Management:
Review and resolve escalated claims requiring resubmission or corrections.
Update trackers with claim escalations and completion status for each facility.
Document all claim actions thoroughly in RCM systems and Zion.
Identify trends in claim errors to inform process improvements and billing practices.
Billing Software Management:
Verify patient demographics and billing information in CMD.
Perform bulk submissions and corrected claim submissions.
Maintain accuracy and compliance with internal and external billing standards.
Process Monitoring and Communication:
Monitor all billing activities to ensure timely and accurate claim processing.
Communicate with Team Leads and management regarding outstanding issues and resolutions.
Track VA and Tricare claim submissions and ensure adherence to requirements.
Operational Efficiency:
Collaborate with internal teams to resolve billing discrepancies and process issues.
Stay updated on VA and Tricare billing guidelines and changes.
Generate insights from trends to improve billing performance and reduce denials.
Experience: 3–6 years in healthcare billing, claims management, or revenue cycle management.
Education: High school diploma or equivalent; certification in medical billing or coding preferred.
Technical Skills: Proficiency in billing software (e.g., Collaborate MD) and EHR systems.
Analytical Skills: Ability to analyze billing data, identify trends, and implement corrective actions.
Communication Skills: Strong verbal and written skills for effective collaboration with internal teams and clients.
Organizational Skills: Ability to manage multiple tasks in a fast-paced, remote environment.
Attention to Detail: High accuracy in claim processing and documentation.
Preferred Experience:
Prior experience in behavioral healthcare billing, including substance use disorder and mental health services.
Experience working in a remote environment.
Familiarity with VA and Tricare claims and submission processes.
At Zealie, you will be part of a mission-driven organization where your expertise in billing and revenue cycle management directly impacts healthcare operations and patient outcomes. We offer a dynamic remote work environment, opportunities for professional growth, and exposure to cutting-edge billing technologies in the behavioral healthcare sector.
Apply Now to join Zealie as a Billing SME and elevate your career in healthcare revenue cycle management.
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