Medical Billing Specialist

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

📋 Description

• Transform clinical encounter data into accurate, compliant claims.

• Submit claims to payers with precision and within deadlines.

• Investigate and rectify denials, rejections, and discrepancies.

• Identify billing issues related to intake, coding, or submission and enhance workflows.

• Collaborate with eCW, Epic, Waystar, and AdvancedMD systems.

• Generate billing reports and perform queries.

• Conduct audits of billing workflows and suggest improvements.

• Partner with clinical and administrative teams to ensure data integrity throughout the revenue cycle.

• Achieve a claim and encounter submission accuracy rate of 98% or higher.

• Ensure prompt resolution of denials and rejections.

• Maintain adherence to payer and regulatory standards.

• Diminish billing errors over time.

• Work in collaboration with clinical and operations teams.

⛳️ Requirements

• Over 5 years of experience in medical billing within primary care or managed care environments.

• Extensive experience with encounter data and claims processes.

• Practical knowledge of eCW and Epic or similar platforms.

• Familiarity with clearinghouses such as Waystar or AdvancedMD.

• Understanding of HMO/PPO workflows and payer regulations.

• Experience in supporting physician billing in a primary care context.

• Strong grasp of end-to-end revenue cycle workflows.

• Knowledge of managed care and value-based billing intricacies, including capitation models.

• Understanding of CPT II codes related to Quality and HEDIS reporting.

• Detail-oriented with strong analytical skills.

• Ability to maintain composure in high-volume situations.

• Proactive approach to issue resolution with an ownership mindset.

• Alignment with the core values of Heart, Excellence, Accountability, Resilience, and Teamwork.

• Must reside within the U.S., with a preference for candidates in Eastern or Central time zones.

🏝️ Benefits

• Competitive annual performance bonus.

• Comprehensive health, dental, and vision insurance.

• Paid time off.

• 401(k) plan with company matching.

• Opportunities for skill development and new challenges.

• Reasonable accommodations provided during the recruitment process.