Insurance Medical Billing Specialist

Remote role Full-time Open position

Job Description:

Manage the end-to-end medical billing process for healthcare services
Responsible for accurate claim submission, timely reimbursements, and maintaining compliance with insurance and healthcare regulations
Prepare, review, and submit accurate medical claims to insurance providers
Ensure proper coding using CPT, ICD-10, and HCPCS before claim submission
Monitor claim status and follow up on unpaid, delayed, or rejected claims
Handle claim corrections, resubmissions, and appeals as needed
Verify patient insurance coverage, benefits, eligibility, co-pays, and deductibles
Communicate insurance details clearly to internal teams or patients when necessary
Track outstanding claims and maintain timely reimbursement follow-ups
Follow up on denied or underpaid claims and provide supporting documentation
Maintain accurate records of payment postings, adjustments, and billing activity
Identify denial trends and recommend corrective actions to improve billing accuracy
Investigate and resolve billing discrepancies and coding-related issues
Ensure all billing practices comply with HIPAA and healthcare regulations
Maintain organized and accurate billing documentation
Stay updated on insurance policies, coding standards, and billing procedures
Generate billing reports and track performance metrics such as claim acceptance rate and AR aging
Collaborate with internal teams to improve billing workflows and collection efficiency
Communicate effectively with insurance representatives and stakeholders

Requirements:

Proven experience in medical billing, insurance billing, or revenue cycle management
Strong knowledge of CPT, ICD-10, and HCPCS coding systems
Experience working with U.S. healthcare insurance providers, including Medicare, Medicaid, and private insurers
Familiarity with EHR, EMR, and medical billing software
Strong understanding of claims processing, denial management, and accounts receivable follow-ups
High attention to detail and accuracy in handling financial data
Strong communication and problem-solving skills
Ability to work independently and manage multiple billing tasks efficiently
Experience in a healthcare, clinic, or medical practice setting is preferred
Certification such as CPC or equivalent is preferred
Experience with Kareo, AdvancedMD, Athenahealth, or similar platforms is preferred
Knowledge of U.S. healthcare compliance and reimbursement processes is preferred

Benefits:

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