SME- Medical Billing

Credense Medical Billing; Hyderabad; On-site; INR 600,000 - 1,200,000; Full time

Job summary

Credense Medical Billing is expanding its charge entry personnel to support US healthcare providers from Hyderabad. The role emphasizes accurate charge entry, fast claim submission, and expert resolution of charge-entry issues using NextGen workflows.

The candidate should bring extensive US RCM experience, strong CPT/HCPCS/ICD-10-CM knowledge, and a proven ability to train and guide junior staff in charge-entry procedures.

Qualifications

• 5+ years of experience in US Healthcare RCM with emphasis on charge entry.
• Significant hands-on experience in charge entry processes.
• Strong familiarity with NextGen Healthcare software platform.
• Understanding of end-to-end charge entry and claim submission workflows.
• Knowledge of CPT, HCPCS, ICD-10-CM, modifiers and POS coding.

Responsibilities

• Perform and oversee charge entry activities for US healthcare providers.
• Review and validate patient demographics, insurance information, CPT, HCPCS, ICD-10, modifiers, units, and other billing information.
• Ensure charges are entered accurately and submitted within defined turnaround times.
• Work extensively on NextGen for charge entry, claim creation, corrections, and related billing activities.
• Identify and resolve charge entry errors, billing discrepancies, and claim-related issues.
• Handle complex and escalated charge entry cases as an SME.
• Provide process guidance and day-to-day support to charge entry teams.
• Conduct quality checks and identify recurring errors or process gaps.
• Support new-hire training, refresher training, and knowledge-sharing sessions.
• Create and maintain process documentation, SOPs, and training materials.
• Monitor team performance against productivity, quality, and turnaround-time targets.
• Coordinate with internal teams and clients to resolve operational issues.
• Analyze error trends and recommend corrective and preventive actions.
• Support process improvement and automation initiatives where applicable.
• Stay updated on US healthcare billing rules, payer requirements, coding guidelines, and RCM best practices.

Skills

US Healthcare RCM

Charge Entry

NextGen Healthcare

Workflow knowledge

CPT/HCPCS/ICD-10-CM

Tools

NextGen Healthcare

Job description

Key Responsibilities

Perform and oversee charge entry activities for US healthcare providers.

Review and validate patient demographics, insurance information, CPT, HCPCS, ICD-10, modifiers, units, and other billing information.

Ensure charges are entered accurately and submitted within defined turnaround times.

Work extensively on NextGen for charge entry, claim creation, corrections, and related billing activities.

Identify and resolve charge entry errors, billing discrepancies, and claim-related issues.

Handle complex and escalated charge entry cases as an SME.

Provide process guidance and day-to-day support to charge entry teams.

Conduct quality checks and identify recurring errors or process gaps.

Support new-hire training, refresher training, and knowledge-sharing sessions.

Create and maintain process documentation, SOPs, and training materials.

Monitor team performance against productivity, quality, and turnaround-time targets.

Coordinate with internal teams and clients to resolve operational issues.

Analyze error trends and recommend corrective and preventive actions.

Support process improvement and automation initiatives where applicable.

Stay updated on US healthcare billing rules, payer requirements, coding guidelines, and RCM best practices.

Required Skills & Experience

5+ years of experience in US Healthcare RCM, preferably with significant experience in Charge Entry.

Strong hands-on experience with NextGen Healthcare software.

Excellent understanding of the complete charge entry and claim submission workflow.

Good knowledge of **CPT, HCPCS, ICD-10-CM, modifiers, POS,