Senior Medical Billing Specialist

Description

Mohenara LLC is seeking an experienced Senior Medical Billing Specialist to join its team at the Civic Center in Bahria Town, Rawalpindi. This full-time, on-site role focuses on managing comprehensive billing operations for US medical practices, ensuring smooth handling of the entire revenue cycle management (RCM) process from start to finish. The ideal candidate brings at least four years of hands-on experience in US medical billing, with a solid background in full-cycle billing and a strong understanding of payer guidelines, reimbursement policies, and compliance standards including HIPAA. In this role, the specialist is responsible for verifying insurance eligibility, submitting and reconciling claims, managing denials and appeals, and maintaining accurate billing records. Strong communication skills in spoken and written English are essential for effective interaction with payers and for clear documentation. While certification such as CPC or CPB and multi-specialty or EDI experience are advantages, the key qualifications include proficiency with electronic health records and practice management systems, along with hands-on experience handling Medicare, Medicaid, and commercial payer requirements. This position does not include team management responsibilities but offers the opportunity to contribute significantly to Mohenara’s efficient revenue cycle processes.

Responsibilities

• Verify insurance eligibility and benefits, including assessing referrals and authorization requirements to ensure claims meet payer prerequisites.
• Review medical service charges thoroughly, prepare and submit accurate claims, and resolve issues related to clearinghouse rejections.
• Post electronic remittance advice (ERA) and explanation of benefits (EOB) payments promptly, reconcile patient accounts, and submit secondary claims when necessary.
• Investigate and resolve claim denials by preparing corrected claims and formal appeals, utilizing effective communication via phone and payer portals to follow up on unpaid claims.
• Maintain detailed and accurate account notes documenting billing procedures, claim adjustments, and communications with insurance payers and medical practices.
• Ensure compliance with HIPAA regulations and billing standards, staying current with updates in payer guidelines and reimbursement policies.
• Collaborate with medical practice staff to support smooth billing workflow and address queries related to claims and payments.
• Utilize electronic health records (EHR) and practice management systems efficiently to manage billing data and reporting requirements.
• Apply knowledge of medical coding standards including ICD-10-CM, CPT, and HCPCS to ensure precise billing and coding practices in line with payer expectations.
• Continuously update skills and knowledge related to revenue cycle management to contribute to process improvements and optimize financial performance.

Experience

4 Years

Apply By

Nov 16, 2026

Required Skills

• HIPAA And Billing Compliance
• Billing and Practice Management Software Proficiency
• Claims Appeals Documentation
• Electronic Remittance Advice (ERA) Processing
• Explanation of Benefits (EOB) analysis
• Commercial Payer Billing
• Medicaid Billing Procedures
• Medicare Billing Procedures
• Medical Coding (ICD-10-CM, CPT, And HCPCS)
• Payer Guidelines And Reimbursement Policies
• Electronic Health Records And Practice Management Systems
• Revenue Cycle Management
• Insurance Eligibility and Benefits Verification
• Payment Posting and Reconciliation
• accounts receivable follow-up
• Denial Management and appeals
• Medical Claims Submission And Scrubbing

Nice to Have Skills

• Clearinghouse & Electronic Data Interchange (EDI) Processes