About this role

Handle high-level billing escalations and serve as a subject matter expert for complex claim issues.
Review claims to identify errors caused by system setup or process gaps.
Collaborate with SYSADMIN to correct systemic configuration issues and validate updates.
Provide data and guidance on affected claims to billing teams and providers for manual resolution.
Support provider and retention teams by explaining billing outcomes and corrective actions clearly.
Document recurring issues and recommend workflow or system improvements.
Mentor Level 1 and Level 2 billing support staff, sharing expertise and best practices.
Lead or participate in small projects related to billing reviews, system changes, and process enhancements.

Bachelor’s degree in Business, Healthcare Administration, Finance, or equivalent work experience.
4–6 years of experience in medical billing, claim review, or revenue cycle management.
Mandatory: Hands-on experience with ClinicMind/Vericle software.
Strong knowledge of billing workflows, claim adjudication, and payer requirements.
Excellent communication skills to interact with providers, billing teams, and technical staff.
Strong analytical and problem-solving abilities with attention to detail.
Basic project management experience (managing timelines, priorities, and stakeholder coordination).

Subject Matter Expert, Billing Specialist

Key skills