Billing Subject Matter Expert (SME)

Delhi - India

Monthly Salary: Not Disclosed

Experience Required: 1-3years

Posted on: 2 hours ago

Vacancies: 1 Vacancy

Job Summary

This is a remote position.

Position Summary

The Billing Subject Matter Expert (SME) plays a key role in ensuring accurate billing copay collection charge posting and payment entry across the full revenue cycle process. This role bridges communication between front-end operations billing representatives and client AR to maintain accuracy compliance and timely revenue posting.

Why Join Us

100% remote
Room to grow
Purpose-driven work
Collaborative team

Perks & Benefits

Paid Time Off (PTO)
Paid U.S. holidays
Paid birthday leave
Monthly health stipend

Key Responsibilities

1. Copay Collection

Review upcoming client appointments in TheraNest to verify copay amounts.
Charge client copay from the stored credit card (CC) before the scheduled appointment.
Send secure SMS payment links to clients if a valid CC is not on file.
Notify the Client AR team if copays remain uncharged or uncollected before the appointment date.
Maintain accurate tracking of copay collections and payment confirmations in the system.

2. Billing Operations

Receive and review daily patient schedules from TheraNest.
Review therapist notes to identify the appropriate service codes (CPT) and corresponding charge amounts.
Create and enter invoices in the billing system with complete and accurate patient demographics.
Ensure all charge entries are properly posted in EZClaim (or other RCM platforms) before insurance submission.
Prepare and submit clean claims to insurance payers while adhering to compliance and documentation requirements.
Coordinate with providers or billing representatives to correct missing or inaccurate information before claim submission.

3. Payment Posting & Reconciliation

Post all insurance and patient payments accurately and promptly into the practice management system.
Record and verify batch totals with date and initials on the payment receipt spreadsheet.
Balance batches daily and run transaction reports for internal review.
Confirm that all EFT deposits and scanned checks are fully posted by month-end close.
Document and communicate payment denials or discrepancies to the Billing AR representative or Billing Director immediately.
Identify payments not paid at contracted or allowed rates and flag them for AR follow-up.
Support month-end reconciliation by ensuring payment accuracy timeliness and complete documentation.

4. Communication & Compliance

Collaborate with AR Credentialing and Clinical teams to resolve claim-related issues.
Maintain up-to-date knowledge of payer policies Medicaid guidelines and coding standards.
Ensure HIPAA compliance and confidentiality across all billing operations.
Participate in billing meetings and share insights or process improvements with leadership.

Preferred Skills & Qualifications

Experience in healthcare billing or RCM (mental health experience preferred).
Working knowledge of TheraNest EZClaim and Waystar.
Strong understanding of CPT codes EOBs payment posting and insurance billing cycles.
Detail-oriented organized and able to multitask in a high-volume environment.
Effective communication and problem-solving skills.
Proficient in Excel and data reconciliation.

Required Skills:

Experience in healthcare billing or RCM (mental health experience preferred). Working knowledge of TheraNest EZClaim and Waystar. Strong understanding of CPT codes EOBs payment posting and insurance billing cycles. Detail-oriented organized and able to multitask in a high-volume environment. Effective communication and problem-solving skills. Proficient in Excel and data reconciliation.

This is a remote position. Position Summary The Billing Subject Matter Expert (SME) plays a key role in ensuring accurate billing copay collection charge posting and payment entry across the full revenue cycle process. This role bridges communication between front-end operations billing repres...