Bilingual Senior Medical Billing & Coding Specialist, Spanish, English

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

📋 Description

• Oversee daily medical billing and coding tasks for the U.S. healthcare system.

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

• Examine patient accounts, medical records, and billing details to ensure precision.

• Apply and interpret CPT, ICD-10, HCPCS, and associated modifier codes.

• Detect and rectify coding or billing inaccuracies leading to claim rejections or denials.

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

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

• Investigate unpaid and underpaid claims, maintaining communication with insurance companies.

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

• Confirm and uphold accurate patient and insurance information.

• Review Explanation of Benefits and Electronic Remittance Advice documentation.

• Identify patterns in denials, payment problems, and billing inconsistencies, recommending corrective measures.

• Liaise with insurance companies, healthcare providers, patients, and internal teams.

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

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

⛳️ Requirements

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

• Direct involvement in a U.S. healthcare environment such as a practice, clinic, dental office, behavioral health organization, or ophthalmology practice.

• Solid comprehension of the U.S. healthcare revenue cycle.

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

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

• Strong knowledge of CPT codes along with familiarity in ICD-10 and HCPCS coding.

• Capacity to identify discrepancies in coding and billing, resolving claim-related challenges.

• Proficiency in both English and Spanish, with the ability to communicate professionally in both languages.

• Advanced computer skills and the ability to navigate healthcare billing systems, EHRs, EMRs, and payer portals.

• Keen attention to detail and accuracy in work.

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

• Experience with healthcare billing software, EHR/EMR systems, clearinghouses, and payer portals is preferred.

• Background in managing complex denials, appeals, and aging Accounts Receivable is preferred.

• CPC, CCS, CPB, CCA, or equivalent certification is preferred but not mandatory.

🏝️ Benefits

• Completely remote work setup.

• Flexible working hours ranging from 15 to 40 hours each week.

• Options for both full-time and part-time employment.

• Work schedule determined by client needs and agreed-upon availability.