Medical Billing Expert for Chronic Care Management

3 weeks ago


Sunnyvale, California, United States IntelliPro Group Inc. Full time
Job Summary

We are seeking a highly skilled Medical Billing Specialist to manage and oversee our billing and revenue cycle processes. This role will focus on ensuring timely and accurate billing for Remote Patient Monitoring, Chronic Care Management, and Medical Nutrition Therapy services.

This Medical Billing Expert will be responsible for managing the complete billing workflow, from validating claims and following up on denials to generating revenue reports.

  • The ideal candidate will have extensive experience in medical billing, a deep understanding of coding practices, and the ability to identify and implement strategies to enhance revenue capture.
  • A strong knowledge of CPT, ICD-10, HCPCS codes, and experience using EHR systems like EPIC, Kareo, eCW, Athena, and others is required.

Key Responsibilities:

Revenue Cycle Management
  • Manage the end-to-end billing process for RPM, CCM, and MNT services, including charge entry, claims submission, and payment posting.
  • Validate patient benefits and verify insurance eligibility by contacting insurance providers.
  • Ensure compliance with all Medicare, State programs, HMO/PPO regulations and guidelines.
Claims Follow-up and Resolution
  • Conduct thorough follow-ups with insurance companies to resolve outstanding claims and denials, ensuring prompt resubmission and appeals.
Revenue Analysis and Improvement
  • Analyze revenue reports, identify trends related to errors, and work to improve revenue cycle performance.
Team Collaboration and Communication
  • Collaborate with internal teams, particularly IT, to streamline billing workflows and enhance system efficiencies.
Compliance and HIPAA
  • Ensure HIPAA compliance throughout the billing process.

Salary: $80,000 - $90,000 per annum, depending on qualifications and experience.



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