Medical Biller, RCM Specialist

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

📋 Description

• Audit and oversee daily submissions from the external third-party medical billing company.

• Cross-check OnlyMD EMR encounters with filed claims to uncover unbilled encounters, coding errors, and overlooked tasks.

• Investigate around 90 days' worth of pending billing and over 500 unsubmitted encounters.

• Communicate with payors and the billing agency to address claim rejections and denials.

• Maintain billing tracking logs and resolve discrepancies related to patient insurance eligibility within OnlyMD.

• Provide Dr. Mann with weekly reports on accounts receivable recovery.

• Monitor claim transmission frequency and highlight systematic vendor errors or delays.

• Audit CPT/ICD-10 coding for behavioral health encounters, therapy sessions, and psychiatric evaluations.

• Identify root causes of unpaid, rejected, or unsubmitted claims and implement corrective actions, appeals, and resubmissions.

• Navigate California medical billing regulations, county/state paperwork, and guidelines for both commercial and government payors.

• Document billing workflows and prepare the practice for transitioning all billing operations in-house.

⛳️ Requirements

• Minimum of 3 years of experience in medical billing and coding, including accounts receivable follow-up, claims auditing, denial management, and medical revenue cycle management (RCM).

• Direct experience in mental/behavioral health billing, covering psychiatric CPT codes, pre-authorizations, and behavioral health payor regulations.

• Familiarity with California state billing regulations, payor guidelines, and local paperwork/credentialing requirements.

• Experience in auditing external billing vendors, tracking missing encounters, and monitoring billing performance metrics.

• Ability to work part-time (approximately 20 hours per week) on a flexible schedule from 10:00 AM to 7:00 PM PST, with full availability for transitioning to a 40 hours per week full-time role.

• A dedicated, private, quiet HIPAA-compliant home office setup.

• High-performance PC or Mac, high-speed internet, backup internet and power solutions, and a headset.

• Preferred hands-on experience with OnlyMD EMR & Billing System or a comparable integrated EMR/billing system.

• Preferred experience in transitioning a clinic from outsourced billing to in-house billing.

🏝️ Benefits

• Competitive salary and flexible working hours.

• Opportunities for professional development and training.

• Supportive work environment focused on continuous improvement.