Medical Billing Specialist

What You’ll Own

Claims Submission & Management

* Prepare, review, and submit medical claims to insurance payers.
* Verify claim accuracy and ensure all required coding and supporting documentation are included.
* Monitor claim status and address submission errors or rejections.

Payment Posting & Reconciliation

* Post insurance payments, adjustments, and patient payments to the appropriate accounts.
* Review Explanation of Benefits (EOBs) and Electronic Remittance Advice (ERA) for payment accuracy.
* Identify and investigate discrepancies between expected and received reimbursements.

Denial Management & Appeals

* Investigate denied and rejected claims to identify underlying issues.
* Prepare and submit corrected claims or appeals within payer deadlines.
* Track denial trends and help prevent recurring billing errors.

Accounts Receivable Follow-Up

* Monitor outstanding claims and unpaid balances.
* Follow up with insurance companies regarding delayed or missing payments.
* Maintain accurate records of aging accounts and escalate unresolved issues when necessary.

Patient & Payer Communication

* Respond to billing-related inquiries from patients and insurance representatives.
* Resolve payment discrepancies and clarify claim-related questions.
* Maintain professional and timely communication with external payers and internal stakeholders.

Compliance & Documentation

* Follow applicable healthcare billing regulations, payer requirements, and internal procedures.
* Maintain accurate billing records and protect confidential patient information.
* Keep shared trackers and Finance team documentation updated.

Requirements

* Proven experience in medical billing, claims processing, or a similar healthcare finance role.
* Strong understanding of medical coding systems, including ICD-10, CPT, and HCPCS.
* Hands-on experience with insurance verification, EOBs, payment posting, and remittance processing.
* Experience using medical billing software or practice management systems.
* Understanding of the complete medical billing and claims lifecycle.
* Strong knowledge of insurance claim follow-ups, denial management, and appeals.
* Excellent attention to detail and strong organizational skills.
* Proficient written and spoken English, with the ability to communicate effectively with insurance payers and internal teams.
* Ability to work independently and manage multiple billing tasks in a remote environment.

Nice to Have

* Experience working with U.S. healthcare billing and insurance processes.
* Familiarity with common clearinghouses and electronic claims submission workflows.
* Experience managing accounts receivable aging reports and identifying reimbursement trends.
* Previous experience supporting a remote Finance or Revenue Cycle Management (RCM) team.

What Makes You a Strong Fit

* You identify billing discrepancies early and take ownership of resolving them.
* You are proactive with claim follow-ups and do not let outstanding items go unattended.
* You can manage repetitive, detail-heavy tasks while maintaining a high level of accuracy.
* You communicate clearly with internal teams and external insurance representatives.
* You understand the importance of patient data confidentiality and handle sensitive information responsibly.
* You are organized, self-motivated, and comfortable working with minimal supervision.

What Success Looks Like

* Medical claims are submitted accurately and within required timelines.
* Payments and adjustments are posted correctly, with discrepancies identified promptly.
* Denied claims are investigated and resolved through timely corrections or appeals.
* Outstanding accounts receivable are consistently monitored and followed up.
* Billing records and shared trackers remain accurate and up to date.
* The Finance team has clear visibility into billing progress, outstanding issues, and potential blockers.

Interview Process

* Initial application review.
* Client interview
* Final selection and offer.