Senior Medical Billing & Coding Specialist

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

📋 Description

• Oversee daily U.S. medical billing and coding operations

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

• Analyze medical records and billing data for precise coding and claims submission

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

• Detect and rectify billing and coding mistakes leading to rejections or denials

• Handle denials, rejected claims, appeals, and corrections

• Conduct Accounts Receivable follow-up and resolve outstanding insurance balances

• Investigate unpaid, underpaid, and denied claims and liaise with insurance companies

• Assist throughout the entire Revenue Cycle Management process

• Review EOBs and ERAs, reconciling payments against submitted claims

• Perform payment posting and identify discrepancies

• Verify and uphold accurate patient and insurance details

• Utilize payer portals, clearinghouses, EHR/EMR systems, and billing platforms

• Recognize recurring billing and denial issues and suggest improvements

• Maintain precise records and documentation

• Communicate with insurance companies, healthcare providers, patients, and internal teams

• Adhere to client-specific billing, coding, compliance, and workflow standards

⛳️ Requirements

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

• Direct experience in a U.S. healthcare practice, clinic, or healthcare organization

• Experience supporting healthcare specialties such as Primary Care, Behavioral Health, Mental Health, Dental, Ophthalmology, or Specialty Care

• Comprehensive understanding of the U.S. healthcare Revenue Cycle Management process

• Practical experience in medical billing, coding, claims submission, denial management, Accounts Receivable, claim follow-up, payment posting, and insurance verification or eligibility

• Familiarity with Medicare, Medicaid, and commercial insurance processes

• Strong knowledge of CPT codes and working familiarity with ICD-10, HCPCS, and modifiers

• Ability to identify billing or coding discrepancies

• Solid understanding of insurance payer processes and requirements

• Proficient computer skills and ability to utilize healthcare software, EHRs/EMRs, clearinghouses, payer portals, and billing platforms

• Exceptional written and verbal communication skills in English

• Keen attention to detail and accuracy

• Capacity to work independently in a remote setting

• Candidates should showcase practical, hands-on U.S. medical billing and coding experience rather than just general healthcare administration

🏝️ Benefits

• Fully remote work arrangement

• Options for full-time and part-time work

• Flexible workload ranging from 15–40 hours per week, based on client needs