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
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