Job Title: Billing Subject Matter Expert (SME)
Location: India (Remote)
Job Type: Full-Time
Experience Required: Proven experience in healthcare billing
Functional Area: Revenue Cycle Management / Medical Billing
Company Overview
Zealie is a rapidly growing Medical Billing Services company specializing in the Behavioral Healthcare industry. Our clients include substance use disorder treatment, addiction recovery, and mental health treatment centers dedicated to improving lives every day. Zealie’s proprietary technology provides data analytics and revenue prediction tools, enabling clients to make strategic decisions and grow their business. Our team is committed to delivering exceptional service and operational excellence.
Role Overview
We are seeking a Billing Subject Matter Expert (SME) to join our Revenue Cycle Management team. The SME will be responsible for ensuring accurate billing processes, claim validation, resubmission, and correction. This role requires expertise in billing systems, strong analytical skills, and the ability to manage escalated claims efficiently.
Key Responsibilities
Escalated Claim Management:
Review escalated claims and update trackers with total escalation amounts per facility.
Handle resubmissions and corrections, documenting all actions in RCM and Collaborate MD (CMD).
Track trends in claim errors to improve billing practices.
Billing Software Management:
Ensure accurate patient demographic data entry in CMD.
Perform bulk claim submissions and corrected claim processing.
Maintain efficiency and accuracy of billing submissions.
Process Monitoring & Communication:
Update trackers with escalation resolutions and completion dates.
Verify correct submission of billing claims.
Communicate outstanding tasks to the Team Lead.
Operational Efficiency & Compliance:
Monitor billing processes for accuracy and timeliness.
Collaborate with internal teams to resolve billing discrepancies.
Submit VA and Tricare claims for applicable facilities and stay current on submission requirements.
Analyze claim denial trends to recommend process improvements.
Qualifications & Skills
Education:
High School Graduate or equivalent. Additional certification in medical billing or coding is a plus.
Experience:
Proven experience in healthcare billing, with strong knowledge of claim verification and submission.
Familiarity with Collaborate MD (CMD) or other billing software preferred.
Prior experience in Behavioral Healthcare billing is advantageous.
Skills & Competencies:
Excellent verbal and written communication.
Strong organizational and multi-tasking abilities.
Technical proficiency with billing software and electronic health record (EHR) systems.
Analytical mindset to review and resolve billing issues.
High attention to detail and accuracy in claims processing.
Ability to work independently in a remote environment.
Why Join Zealie
Contribute to life-changing healthcare services through efficient revenue cycle management.
Work in a dynamic and remote-friendly environment.
Gain exposure to behavioral healthcare billing processes and advanced EHR/billing technologies.
Collaborate with a dedicated team committed to operational excellence and client success.
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