The Medical Billing Specialist plays a critical role in managing the complete billing cycle, including Revenue Cycle Management (RCM) and Accounts Receivable (A / R). This role ensures efficient billing operations by handling claims, investigating denials, and performing end-to-end billing tasks to optimize revenue for healthcare practices.
Key Responsibilities :
- End-to-End Revenue Cycle Management (RCM) : Oversee the entire billing cycle from claims submission to final reimbursement, ensuring each step is accurately and efficiently managed.
- Accounts Receivable (A / R) Collections : Track and manage unpaid bills, performing follow-ups on outstanding claims and resolving collection issues to maximize revenue.
- Claims Denial Investigation and Resolution : Investigate denied claims, identify errors or required corrections, and resubmit claims with appropriate adjustments.
- Claims Resubmission and Correction : Manage backend tasks related to claim resubmission, verifying accuracy, and implementing corrections as needed to avoid delays in reimbursement.
- Documentation and Compliance : Ensure all billing activities are documented by regulatory standards and compliance requirements, including HIPAA.
Requirements
Proven experience in medical billing with exposure to RCM and A / R processes.Experience with claim denial management and collections processes.Proficiency in English communication, both written and verbal.Proficient in virtual office tools, EHR systems, and communication platforms.Strong customer service and critical thinking skills.Understanding of HIPAA regulations and the importance of patient data confidentiality.Strong problem-solving skills and ability to work with minimal supervision.Willingness to work in US time zones (PST, EST, CST).High school diploma or equivalent.System and Work Setup Requirements :
A stable and high-speed internet connection preferably 25 MBPS or higher with backup in cases of power interruption or service provider issues.Own PC / laptop with 8GB RAM, and a processor of Core i5 / AMD Ryzen 3 / 2013 Mac equivalent or higher; Windows 10 or above / Catalina 10.15 or newer; with up-to-date web browsers, and security software, 500GB / 128 SSD storageHeadset / earphone with noise cancellation and webcam at 720p or higher resolutionA designated, quiet, and well-organized workspace free from distractions to facilitate focused workBenefits
Permanent remote work setupCompetitive starting rate paid in USDInternet AllowanceHMO insurance (PH)Retirement FundPaid US holidaysPaid Vacation and Sick Leaves