Senior Medical Billing, RCM Specialist

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

📋 Description

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

• Prepare, analyze, and submit claims to Medicare, Medicaid, and various commercial insurance providers.

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

• Utilize CPT, ICD-10-CM, HCPCS, and relevant modifiers in billing practices.

• Detect and rectify billing and coding discrepancies that could lead to claim rejections or denials.

• Handle denied, rejected, unpaid, and underpaid claims efficiently.

• Conduct insurance follow-ups and liaise with payers regarding pending claims.

• Execute accounts receivable follow-up, including aging accounts receivable.

• Submit corrections, reconsiderations, and appeals for claims.

• Analyze EOBs and ERAs to resolve payment discrepancies.

• Perform or assist with payment posting and account reconciliation tasks.

• Confirm patient and insurance details for accuracy.

• Collaborate with clearinghouses, payer portals, EHR/EMR systems, and billing platforms.

• Monitor outstanding accounts and take necessary actions for resolution.

• Identify recurring billing, denial, and payment issues and communicate findings to the relevant team.

• Maintain precise billing documentation while adhering to client-specific protocols.

• Operate independently in a remote setting while achieving productivity, accuracy, and turnaround time goals.

⛳️ Requirements

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

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

• Comprehensive understanding of the U.S. healthcare revenue cycle.

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

• Familiarity with U.S. insurance payers.

• Knowledge of EHR/EMR systems, clearinghouses, payer portals, and/or medical billing software.

• Strong attention to detail and capability to independently handle billing responsibilities.

• Excellent written and verbal communication skills in English.

• Ability to work effectively in a fully remote setting.

🏝️ Benefits

• Fully remote work arrangement.

• Options for full-time and part-time employment.

• Flexibility to work 15–40 hours per week.

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