Subject Matter Expert Billing Specialist

4 days ago

Santa Clara Bulacan, Philippines Vericle Pacific Inc Full time ₱1,200,000 - ₱2,400,000 per year

ClinicMind's core values—Excellence

  • Learning
  • Teamwork  guide everything we build.

With 150 in‑house analysts, half a dozen BPO partners, and a proprietary billing platform, we now need a manager to deliver best‑in‑class collections, continue to improve performance, automate, and meet the RCM needs of a rapidly growing client base.

Overview

We are seeking a Level 3 Billing Support / Billing Review Subject Matter Expert (SME) to join our team. This role serves as the final point of escalation for complex billing concerns and systemic claim issues. The SME team ensures accuracy in claim processing, resolves systemic billing setup problems, and provides expert support to billing staff, providers, and retention teams. Experience with ClinicMind/Vericle software is required.

Key Responsibilities

  • Handle high-level billing escalations and serve as a subject matter expert for complex claim issues.
  • Review claims to identify errors caused by system setup or process gaps.
  • Collaborate with SYSADMIN to correct systemic configuration issues and validate updates.
  • Provide data and guidance on affected claims to billing teams and providers for manual resolution.
  • Support provider and retention teams by explaining billing outcomes and corrective actions clearly.
  • Document recurring issues and recommend workflow or system improvements.
  • Mentor Level 1 and Level 2 billing support staff, sharing expertise and best practices.
  • Lead or participate in small projects related to billing reviews, system changes, and process enhancements.

Qualifications

  • Bachelor's degree in Business, Healthcare Administration, Finance, or equivalent work experience.
  • 4–6 years of experience in medical billing, claim review, or revenue cycle management.
  • Mandatory: Hands-on experience with ClinicMind/Vericle software.
  • Strong knowledge of billing workflows, claim adjudication, and payer requirements.
  • Excellent communication skills to interact with providers, billing teams, and technical staff.
  • Strong analytical and problem-solving abilities with attention to detail.
  • Basic project management experience (managing timelines, priorities, and stakeholder coordination).

Preferred Skills

  • Prior experience collaborating with system administrators on billing setups.
  • Knowledge of compliance standards and payer regulations.
  • Ability to train or mentor junior staff.

Must Have:

  1. High comfort level working on Eastern Time Zone/US Shift
  2. Good internet access at home
  3. Mobile Hotspot
  4. Laptop/Desktop with at least 16 GB

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