Senior Medical Billing Executive

XenMD, a US-focused healthcare services company specializing in medical billing, revenue cycle management (RCM), credentialing, prior authorization, denial management, and practice support, is seeking a detail-oriented Senior Medical Billing Executive. This full-time role is based in Rawalpindi / Bahria Town, Pakistan, and operates on a night shift aligned with US healthcare hours. The position involves managing daily medical billing and revenue cycle activities for US healthcare clients, ensuring accuracy and efficiency in claims processing and accounts receivable management.

Key Responsibilities

- Manage end-to-end medical billing and revenue cycle processes, including verifying patient demographics, insurance, provider information, and claim accuracy.
- Enter and review charges based on medical documentation and provider encounters.
- Submit electronic and paper claims to commercial insurers, Medicare, Medicaid, and Medicare Advantage payers.
- Verify insurance eligibility and benefits as required.
- Monitor claim acceptance and rejection reports, promptly correcting and resubmitting rejected claims.
- Track claim status and follow up with insurance companies to resolve processing issues.
- Analyze insurance denials, rejections, and underpayments to identify root causes and implement corrective actions.
- Prepare and submit corrected claims and appeals; conduct regular accounts receivable (AR) follow-up on outstanding claims.
- Maintain accurate AR documentation and escalate complex payer issues when necessary.
- Post insurance and patient payments accurately, including contractual adjustments, write-offs, deductibles, copays, and coinsurance.
- Reconcile Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs) with posted payments, identifying discrepancies.
- Utilize payer portals for eligibility verification, claim submission, status checks, and communication with insurance representatives.
- Coordinate with providers and client practices to obtain missing information such as medical records, authorizations, and referrals.
- Communicate claim issues and provide regular updates on claim status, AR, denials, and outstanding matters.
- Maintain accurate billing and AR records; prepare weekly and monthly reports.
- Monitor key RCM metrics including clean claim rate, denial rate, days in AR, and collection rate.
- Conduct quality checks to minimize billing errors and meet productivity and quality targets.

Required Qualifications

- Minimum of 3 years’ experience in US medical billing or healthcare revenue cycle management.
- Strong knowledge of US healthcare insurance, medical billing processes, and payer-specific requirements.
- Experience with Medicare, Medicaid, Medicare Advantage, and commercial insurance plans.
- Proficiency in claim submission, rejection and denial management, and AR follow-up.
- Familiarity with EOBs, ERAs, CPT, HCPCS, ICD-10, modifiers, and place of service codes.
- Experience working with payer portals.
- Excellent attention to detail and ability to identify billing discrepancies.
- Strong written and verbal communication skills.
- Ability to work independently and manage multiple client accounts.
- Good organizational and time-management skills.
- Proficiency in Microsoft Excel and basic office tools.

Preferred Qualifications and Benefits

- Experience with medical billing software or EHR/PM systems such as Tebra, Office Ally, SimplePractice, Kareo, AdvancedMD, eClinicalWorks, NextGen, or RXNT.
- Background in specialties including Primary Care, Behavioral Health, ABA, Mental Health, Physical Therapy, Home Health, Cardiology, OBGYN, Dermatology, Pain Management, or other physician and outpatient specialties.
- Knowledge of medical coding and payer-specific billing requirements.
- Experience handling appeals, complex denials, and managing high-volume claims and AR.
- Competitive salary ranging from Rs80,000 to Rs110,000 per month, based on experience and qualifications.
- Opportunities for professional growth, training, development, and career advancement within XenMD.
- Performance-based incentives and the chance to work with multiple US healthcare specialties.

The ideal candidate will maintain high billing accuracy, submit claims within required timelines, consistently follow up on outstanding claims, reduce avoidable denials, maintain complete claim documentation, meet productivity targets, and uphold professional communication standards. Compliance with HIPAA and company confidentiality policies is essential. This position requires in-person attendance at the specified locations.