Medical Billing Specialist (ENG)

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:

• Internet: Minimum speed of 25 Mbps or higher, with a reliable backup connection available in case of power outages or service provider issues.
• Processor: Intel Core i5 7th Generation or higher (or equivalent).
• Memory: 8 GB RAM.
• Storage: 256 GB SSD or HDD with at least 50% free space available.
• Webcam: 720p resolution or higher.
• Operating System: Windows 10 or later (or equivalent).
• Audio Equipment: Noise-canceling earphones or headset.
• Workspace: A designated, quiet, and organized workspace free from distractions to ensure productivity and focus.

Benefits

• Permanent remote work setup