Medical Billing Expert

Cognitive Healthcare International; Pakistan; On-site; PKR 1,200,000 - 2,400,000; Full time

Job summary

Cognitive Healthcare International is seeking an experienced Revenue Cycle Specialist to optimize provider reimbursement with a patient-centric approach. The role demands meticulous attention to detail, problem-solving in denial management, and leadership in building billing practices.

The ideal candidate has 5+ years in full-cycle medical billing in high-volume settings, with proficiency in major RCM platforms and HIPAA compliance.

Qualifications

• Bachelor's degree in Healthcare Administration, Finance, or related field.

Responsibilities

• Manage end-to-end billing processes, including charge entry, claims submission, and payment posting.
• Conduct thorough insurance verification and eligibility checks, handle prior authorizations, and perform diligent AR follow-up.
• Analyze EOBs and ERAs to resolve denials, file timely appeals, and perform regular billing audits to ensure revenue optimization and HIPAA compliance.
• Coordinate RPM, CCM, and RTM billing cycles to capture all eligible clinical revenue.

Skills

Athenahealth

Kareo

AdvancedMD

eClinicalWorks

Epic

CPT coding

ICD-10 coding

HCPCS coding

Clearinghouse systems

Availity

Medicare/Medicaid portals

Attention to detail

Analytical reasoning

Patient collections

Excel

Google Sheets

Team leadership

Building medical billing practices

Communicating with US counterparts

Education

Bachelor's degree in Healthcare Administration/Finance

CPC or CPB certification (AAPC/AHIMA)

Tools

NextGen

Cerner

DrChrono

Job description

About The Role

The ideal candidate is a meticulous and proactive revenue cycle professional who thrives on accuracy and compliance. They possess a problem-solving mindset aimed at optimizing provider reimbursement while maintaining a patient-centric approach to billing inquiries and financial transparency.

About The Role

The ideal candidate is a meticulous and proactive revenue cycle professional who thrives on accuracy and compliance. They possess a problem-solving mindset aimed at optimizing provider reimbursement while maintaining a patient-centric approach to billing inquiries and financial transparency.

Experience

• Minimum of 5 years of hands-on experience in the full cycle of Medical Billing and Revenue Cycle Management (RCM).
• Proven track record in handling multi-specialty billing, complex denial management, and large-scale AR follow-up within a high-volume clinical or third-party billing environment is essential.

Key Responsibilities

• Manage end-to-end billing processes, including charge entry, claims submission, and payment posting.
• Conduct thorough insurance verification and eligibility checks, handle prior authorizations, and perform diligent AR follow-up.
• Analyze EOBs and ERAs to resolve denials, file timely appeals, and perform regular billing audits to ensure revenue optimization and HIPAA compliance.
• Coordinate RPM, CCM, and RTM billing cycles to capture all eligible clinical revenue.

Required Skills

• Expert proficiency in Athenahealth, Kareo, AdvancedMD, eClinicalWorks, and Epic.
• Advanced knowledge of CPT, ICD-10, and HCPCS coding methodologies.
• Strong technical command over clearinghouse systems, Availity, and Medicare/Medicaid portals.
• Essential soft skills include exceptional attention to detail, strong analytical reasoning, professional communication for patient collections, and advanced proficiency in Excel and Google Sheets for financial reporting.
• Strong team leadership and communication skills
• Experience in building medical billing practices from scratch
• Excellent at communicating with US counterparts.

Education & Certification

• A Bachelor's degree in Healthcare Administration, Finance, or a related field is preferred.
• Must hold active professional certifications such as Certified Professional Coder (CPC) or Certified Professional Biller (CPB) from AAPC or AHIMA.

Additional Requirements

• Experience with NextGen, Cerner, or DrChrono is highly desirable.
• Familiarity with specialized value-based care billing models and remote patient monitoring (RPM) regulations will be considered a significant advantage.
• Bilingual proficiency and prior experience in an audit-heavy environment are a plus.