Bilingual Senior Medical Billing, RCM Specialist – English, Spanish

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

📋 Description

• Oversee daily U.S. medical billing and revenue cycle operations

• Prepare, examine, and submit precise claims to Medicare, Medicaid, and various commercial insurance providers

• Inspect patient accounts, medical records, charges, and insurance details for billing precision

• Apply and interpret CPT, ICD-10-CM, HCPCS, and relevant modifiers

• Detect and rectify billing and coding discrepancies

• Manage claim rejections, denials, corrections, appeals, and resubmissions

• Conduct accounts receivable follow-up on overdue and aging claims

• Investigate unpaid, underpaid, and incorrectly processed claims, following up with insurance providers

• Review EOBs and ERAs, reconciling payments with patient accounts

• Carry out or assist in payment posting and account reconciliation

• Confirm patient eligibility, insurance details, and benefits

• Utilize payer portals, clearinghouses, and billing systems to research and resolve claim issues

• Monitor outstanding accounts receivable and advance accounts towards resolution

• Recognize recurring billing, coding, denial, or payment challenges and communicate trends

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

• Maintain precise billing documentation and adhere to client-specific processes and compliance standards

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

⛳️ Requirements

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

• Direct experience supporting the U.S. healthcare revenue cycle

• Practical experience in medical billing, medical coding, CPT, ICD-10-CM, HCPCS, claims submission, denial management, accounts receivable, insurance/payer follow-up, and revenue cycle management

• Familiarity with U.S. insurance payers, including commercial insurance and/or Medicare/Medicaid

• Knowledge of EHR/EMR systems, clearinghouses, payer portals, or healthcare billing software

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

• Strong attention to detail and the ability to independently manage billing tasks and follow up on outstanding accounts

• Comfortable working remotely and fulfilling client-specific productivity and quality expectations

• Medical billing or coding certification such as CPC, CCS, CPB, or CCA is preferred but not mandatory

• Experience with aging accounts receivable and complex denials is preferred

• Experience with appeals and payer disputes is preferred

• Experience with payment posting and EOB/ERA reconciliation is preferred

• Experience with Medicare and Medicaid billing is preferred

• Experience with multiple insurance payers and payer portals is preferred

• Experience in primary care, behavioral health/mental health, ophthalmology, dental, specialty clinics, or other U.S. healthcare practices is preferred

🏝️ Benefits

• Fully remote work arrangement

• Options for full-time and part-time employment

• Flexible schedule of 15–40 hours per week

• Work hours aligned with U.S. business hours based on client needs and agreed availability