Medical Billing Specialist

Accountabilities: • Medical Billing & RCM: Manage day-to-day billing activities across the revenue cycle, including claims processing, denial management, follow-ups, collections, and account documentation.

• Claims Review: Review claims for accuracy, including diagnosis and procedure code linkage, appropriate billing modifiers, and compliance with applicable payer requirements before submission.

• Denial Management: Analyze EOBs and ERAs to identify non-payment and denial reasons, investigate root causes, and take appropriate action to resolve rejected or denied claims.

• Claims Submission: Prepare and submit initial and secondary claims in accordance with payer guidelines while ensuring billing information is complete and accurate.

• Claims Follow-Up: Manage claim queues and follow-up workflows, research payer portals and insurance websites, and proactively pursue unpaid or rejected claims through resolution.

• Account Management: Support assigned client accounts by responding to billing-related questions, maintaining accurate account notes, and helping ensure outstanding balances are addressed promptly.

• Collections: Support collection activities and contribute to timely resolution of outstanding accounts while maintaining professional and customer-focused communication.

• Quality & Productivity: Perform claims scrubbing and billing quality checks while consistently meeting productivity, accuracy, turnaround-time, and service expectations.

• Stakeholder Communication: Communicate professionally with insurance companies, clients, patients, and provider offices when required to clarify billing issues and facilitate resolution.

• Independent Work: Manage assigned responsibilities with minimal supervision, adapt quickly to established workflows, and maintain consistent performance in a remote working environment.

Requirements

• U.S. Medical Billing Experience: Minimum of 3 years of hands-on experience in U.S. medical billing and Revenue Cycle Management (RCM).

• RCM Expertise: Strong practical knowledge of medical billing workflows, including claims processing, denial management, claims follow-up, collections, and account management.

• EOB & ERA Knowledge: Demonstrated ability to read and interpret Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs), identify payment issues, and determine appropriate next steps.

• Coding & Claims Knowledge: Experience reviewing diagnosis and procedure code relationships, applying billing modifiers, and performing claims scrubbing and quality checks.

• Payer Systems: Experience working with insurance payer portals, insurance websites, medical billing platforms, and related systems to research and resolve claims.

• Analytical Skills: Strong organizational, analytical, and problem-solving abilities, with a high level of attention to detail and accuracy.

• Communication: Strong written and verbal English communication skills, with the ability to interact professionally with payers, clients, patients, and healthcare offices.

• High-Volume Environment: Experience working in high-volume medical billing environments is preferred, particularly where productivity and turnaround-time targets are important.

• Specialty Experience: OBGYN medical billing experience is strongly preferred.

• EHR & Practice Management Systems: Experience with systems such as eClinicalWorks (eCW), Aprima, Medisoft, Veradigm, Nextech, CureMD, Office Practicum, or NextGen is an advantage.

• Remote Work: Previous remote work experience is preferred, along with the ability to work independently and maintain productivity with minimal supervision.

• Technical Setup: Ability to work with Windows 10 or 11, a minimum Intel i5/Ryzen 5 or equivalent processor, at least 16 GB RAM recommended, and a minimum 256 GB SSD. Dual monitors are preferred.

• Internet Connectivity: Reliable high-speed internet with ping/latency below 50 ms and download and upload speeds of at least 100 Mbps. Fiber internet with wired Ethernet/LAN is preferred.

• Professional Workspace: A quiet, professional workspace and noise-canceling headset are required. A webcam is also required, while a backup internet connection is preferred.

Benefits

• Remote Work: Fully remote, full-time position with the ability to work from India while supporting U.S. business hours.

• Professional Growth: Opportunity to develop deeper expertise in U.S. medical billing, RCM, claims management, denial resolution, and healthcare account operations.

• Specialized Experience: Exposure to complex billing workflows, payer requirements, collections, and healthcare practice management systems.

• Career Development: Potential to strengthen experience across U.S. healthcare revenue cycle operations and build expertise with leading EHR and practice management platforms.

• Work Environment: A structured remote setup designed for independent professionals who value flexibility, focused work, and established workflows.

• Additional Benefits: Salary, healthcare, paid leave, and other employee benefits may be provided according to the partner company's applicable policies.

How Jobgether works: We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team. We appreciate your interest and wish you the best!  Why Apply Through Jobgether?    Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.     #LI-CL1