Bilingual Senior Medical Billing and Coding Specialist – Spanish, English

This is a fully remote position, open to applicants in Colombia.

📋 Description

• Oversee daily U.S. medical billing and coding operations.

• Prepare, review, and submit claims to Medicare, Medicaid, and various commercial insurance providers.

• Assess patient accounts, medical records, and billing data for precision.

• Utilize and interpret CPT, ICD-10, HCPCS, and relevant modifier codes.

• Detect and rectify coding or billing mistakes that could lead to claim rejections or denials.

• Handle denials, rejected claims, appeals, and necessary claim corrections.

• Conduct Accounts Receivable follow-up and track outstanding balances.

• Investigate unpaid and underpaid claims, liaising with insurance companies as needed.

• Assist in the Revenue Cycle Management process from charge entry to payment and account resolution.

• Verify and uphold accurate patient and insurance information.

• Analyze Explanation of Benefits and Electronic Remittance Advice.

• Recognize trends in denials, payment complications, and billing inconsistencies, recommending corrective measures.

• Engage in communication with insurance companies, healthcare providers, patients, and internal teams.

• Maintain precise documentation and adhere to client-specific billing and compliance protocols.

• Work autonomously in a remote setting while achieving productivity, accuracy, and turnaround-time goals.

⛳️ Requirements

• At least 3 years of practical experience in U.S. healthcare medical billing and coding.

• Direct experience within a U.S. healthcare practice, clinic, dental practice, behavioral health organization, ophthalmology practice, or similar healthcare environment.

• Comprehensive understanding of the U.S. healthcare revenue cycle.

• Practical experience with medical billing, medical coding, claims submission, denial management, Accounts Receivable, payment posting, claim follow-up, and Revenue Cycle Management.

• Familiarity with Medicare, Medicaid, and commercial insurance payers.

• Solid working knowledge of CPT codes and familiarity with ICD-10 and HCPCS coding.

• Capability to identify coding and billing discrepancies and resolve claim-related challenges.

• Proficient in both English and Spanish, with professional communication skills in both languages.

• Strong computer skills and proficiency in navigating healthcare billing systems, EHRs, EMRs, and payer portals.

• Exceptional attention to detail and accuracy.

• Ability to work independently and prioritize tasks in a remote environment.

• Preferred experience with healthcare billing software, EHR/EMR systems, clearinghouses, and payer portals.

• Preferred experience in managing complex denials, appeals, and aging Accounts Receivable.

• Medical billing or coding certification such as CPC, CCS, CPB, CCA, or equivalent is a plus but not mandatory.

🏝️ Benefits

• Opportunity for professional growth and advancement.

• Flexible work environment with remote options.

• Competitive salary and comprehensive benefits package.

• Supportive team culture promoting collaboration and innovation.