Medical Billing Specialist

Medical Billing Specialist
Full-Time | Remote | Healthcare

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Seeking an experienced Medical Billing Specialist to support U.S.-based healthcare practices on a full-time remote basis. This is a billing-first role built for professionals who know the full revenue cycle, not just one piece of it, and who take ownership of the financial health of the practices they support.

In this role, you will manage the complete billing cycle: claim submission, payment posting, denial management, accounts receivable follow-up, and reporting. You will work directly with practice leadership and administrative teams to ensure claims are clean, payments are collected, and outstanding balances are resolved in a timely manner. You may also provide light support to front desk and administrative functions as a secondary responsibility.

KEY RESPONSIBILITIES

Claims Submission & Billing Operations
- Process and submit insurance claims accurately and in a timely manner via EMR and clearinghouse systems
- Manage the full billing cycle including claim creation, submission, tracking, and follow-up
- Handle primary and secondary insurance claims, including out-of-network and manual tracking requirements
- Ensure all claims are submitted with correct coding, documentation, and payer-specific requirements
- Resolve billing discrepancies by identifying root causes, correcting errors, and rebilling claims as needed
- Ensure compliance with billing and coding regulations and maintain clean documentation for audit readiness

Accounts Receivable & Payment Management
- Monitor and reconcile the accounts receivable ledger and maintain accurate, up-to-date A/R records
- Follow up on outstanding balances, unpaid claims, and overdue accounts to support healthy cash flow
- Post insurance and patient payments to accounts accurately and ensure proper allocation
- Post zero-balance EOBs and process patient refunds as required
- Generate and distribute monthly statements to patients and clients
- Support collections workflows and escalate unresolved balances as appropriate
- Generate billing and A/R reports for practice leadership on a regular basis

Denials Management & Appeals
- Review denied claims promptly, research denial reasons, and determine the appropriate course of action
- Prepare and submit appeals with supporting documentation to secure proper reimbursement
- Track denial trends and communicate findings to leadership to support process improvements
- Follow up on appealed claims and rework as needed until resolution
- Identify and help prevent future denials through accurate claim preparation and payer knowledge

Patient Billing Communication
- Make outbound calls to patients or guarantors to follow up on outstanding balances, declined payments, or billing questions
- Communicate billing details, payment options, and insurance responsibilities clearly and professionally
- Respond to patient inquiries related to statements, claims, and account balances via phone and email
- Document all billing-related communications and update patient records accordingly

Administrative & Reporting Support
- Maintain accurate electronic patient records and billing documentation within the EMR
- Track referrals, plans of care, and authorization-related billing requirements as needed
- Generate key performance and billing reports for management review
- Support insurance verification and benefits checks as needed to ensure billing accuracy
- Assist with administrative workflows, front desk backup duties, or special projects as assigned by the client
- Maintain strict HIPAA compliance and patient confidentiality at all times

QUALIFICATIONS

Required
- 2+ years of hands-on medical billing experience: this is not an entry-level role
- Proven experience managing the full revenue cycle: claim submission, payment posting, A/R follow-up, and denials
- Strong working knowledge of insurance billing processes, payer requirements, and reimbursement rules
- Experience with denials management, including researching, correcting, appealing, and tracking claims to resolution
- Solid understanding of EOB interpretation, payment reconciliation, and accounts receivable principles
- Ability to handle both primary and secondary insurance claims, including manual follow-up processes
- Excellent written and verbal English communication skills: clear phone communication with patients and payers is essential
- Strong attention to detail, accuracy, and follow-through across all billing activities
- Ability to work independently, self-direct daily tasks, and meet targets without close supervision
- Reliable home office setup with a stable internet connection suitable for HIPAA-compliant remote work

Preferred
- Experience in an outpatient healthcare setting: physical therapy, occupational therapy, speech therapy, or similar specialties
- Familiarity with common healthcare EMR and billing platforms (e.g., Prompt, WebPT, Raintree, or similar)
- Experience with Medicare, Medicaid, workers' compensation, and out-of-network billing
- Background working with multi-provider or high-volume clinic environments
- Comfort with Google Workspace, Microsoft Office (Word/Excel), and cloud-based communication tools

WHAT WE LOOK FOR
- Ownership: you treat the practice's A/R like your own and don't let claims sit unresolved
- Expertise: you can read an EOB, identify why a claim was denied, and know exactly what to do next
- Initiative: when something is off, you flag it, fix it, and help prevent it from happening again
- Reliability: your client team counts on your daily output; you show up, you deliver, and you communicate clearly
- Professionalism: you handle patient billing calls with patience, empathy, and accuracy

BENEFITS
- Competitive salary commensurate with experience
- Opportunities for professional development and long-term career growth
- Work within a dynamic, collaborative, and supportive team environment
- Stable, full-time remote employment with U.S.-based healthcare clients
- Make a meaningful impact by helping practices serve their patients and communities