Bilingual Senior Medical Billing 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, review, and accurately submit claims to Medicare, Medicaid, and commercial insurance providers.

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

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

• Detect and rectify billing and coding mistakes prior to or following claim submission.

• Handle claim rejections, denials, corrections, appeals, and resubmissions.

• Conduct accounts receivable follow-up on outstanding and aged claims.

• Investigate unpaid, underpaid, and improperly processed claims and liaise with insurance payers.

• Review EOBs and ERAs while reconciling payments against patient accounts.

• Execute or assist with payment posting and account reconciliation.

• Verify patient eligibility, insurance details, and benefits as needed.

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

• Monitor outstanding accounts receivable and work towards their resolution.

• Identify recurring billing, coding, denial, or payment problems and relay trends to the relevant team.

• Communicate in a professional manner with insurance companies, providers, patients, and internal teams.

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

• Operate independently in a remote setting, consistently meeting accuracy, productivity, and turnaround time expectations.

⛳️ Requirements

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

• Direct involvement in supporting the U.S. healthcare revenue cycle.

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

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

• Working knowledge of EHR/EMR systems, clearinghouses, payer portals, or healthcare billing software.

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

• Strong attention to detail and the capability to independently manage billing tasks and follow up on pending accounts.

• Comfortable working remotely while meeting client-specific productivity and quality standards.

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

• Preferred experience in managing aging accounts receivable and complex denials.

• Preferred experience with appeals and disputes with payers.

• Preferred experience in payment posting and EOB/ERA reconciliation.

• Preferred experience in Medicare and Medicaid billing.

• Preferred experience working with multiple insurance payers and payer portals.

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

🏝️ Benefits

• Fully remote work setup.

• Flexible workload ranging from 15 to 40 hours per week.

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

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