Medical Billing Specialist (CCM/APCM)

NKU Technologies; Lahore; On-site; PKR 16,607,000 - 22,142,000; Full time

Job summary

NKU Technologies in Lahore is seeking a detail-oriented Medical Billing Specialist to join our Revenue Cycle Management team. You will manage end-to-end US billing for CCM and APCM programs, ensuring accurate claims, on-time submissions, and compliance with Medicare and payer guidelines.

You will collaborate with healthcare providers, insurance companies, and internal teams to reduce denials, resolve issues, and support efficient revenue cycle operations, while maintaining precise records in the

Qualifications

• 3 to 4 years of hands-on US Medical Billing/RCM experience.
• Strong CCM/APCM billing knowledge and Medicare rules.
• Experience handling claim denials, appeals, and AR.
• Proficient in ICD-10, CPT, HCPCS codes.
• Experience with PMS, EHR, and Excel.
• Excellent written and verbal communication skills.
• Ability to manage high claim volumes with productivity targets.

Responsibilities

• Prepare, review, and submit CCM/APCM claims to Medicare and payers.
• Verify patient eligibility before submission.
• Ensure CCM/APCM billing uses correct HCPCS/G-codes.
• Review CCM time logs to support CPT codes billed.
• Investigate and resolve denied or rejected claims (appeals, corrections).
• AR follow-up to reduce aging and improve collections.
• Maintain accurate billing records in the practice management system.
• Stay updated with CMS guidelines and payer policies.

Skills

Hands-on US Medical Billing/RCM

Strong CCM/APCM knowledge

Analytical skills

Attention to detail

Written and verbal communication

High-volume claim handling

Tools

Practice Management Systems (PMS)

EHR platforms

Microsoft Excel

Job description

We are seeking a detail-oriented and experienced Medical Billing Specialist to join our growing Revenue Cycle Management (RCM) team. In this role, you will manage the end-to-end billing process for US healthcare providers, with a focus on Chronic Care Management (CCM) and Advanced Primary Care Management (APCM) programs. You will make sure claims are accurate, submitted on time, and compliant with Medicare, and payer guidelines.

You will work closely with healthcare providers, insurance companies, and internal teams to resolve billing issues, reduce claim denials, and support smooth revenue cycle operations.

Key Responsibilities

• Prepare, review, and submit accurate claims for CCM and APCM services to Medicare, Medicare Advantage, and commercial payers.
• Verify patient insurance eligibility, benefits, and coverage before claim submission.
• Confirm that patient consent, care plans, and program enrollment are in place before billing CCM and APCM services.
• Review monthly CCM time logs to make sure billed time supports the CPT code submitted (e.g., 99490, 99439, 99487, 99489).
• Bill APCM services under the correct monthly HCPCS G-codes based on patient complexity level.
• Make sure CCM and APCM services are not billed together for the same patient in the same period, and check for overlap with other care management services.
• Enter charges, payments, and adjustments accurately in the billing system.
• Investigate and resolve denied or rejected claims through timely follow-up, appeals, and claim corrections.
• Work on AR follow-up to reduce aging and improve collections.
• Coordinate with insurance companies, clinics, and care teams to resolve billing discrepancies.
• Maintain accurate records of billing activity and communications in the practice management system.
• Stay up to date with CMS guidelines, payer policies, and annual billing updates.
• Contribute to process improvements that increase billing efficiency and claim acceptance rates.

Requirements

• 3 to 4 years of hands‑on experience in US Medical Billing or Revenue Cycle Management (RCM).
• Good understanding of CCM and/or APCM billing, or similar Medicare care management programs (such as RPM or TCM).
• Strong knowledge of Medicare billing rules and requirements.
• Experience managing claim denials, including root cause analysis, appeals, resubmissions, and AR.
• Working knowledge of ICD-10, CPT, and HCPCS codes as they apply to billing.
• Familiarity with eligibility verification, pre-authorizations, and claim processing for commercial and government payers.
• Experience with Practice Management Systems (PMS), EHR platforms, and Microsoft Excel.
• Strong analytical skills with attention to detail and numerical accuracy.
• Ability to manage high claim volumes while meeting productivity and quality targets.
• Good written and verbal communication skills.

Preferred Qualifications

• Certification in Medical Billing (such as CPB) or a related field.
• Direct experience with CCM or APCM billing.
• Experience working with US healthcare providers or medical billing companies.