Medical Billing Specialist

Accountabilities

• Oversight of end-to-end billing activities, ensuring claims are accurate, compliant, and processed efficiently.
• Strong attention to detail, analytical thinking, and the ability to identify opportunities for process improvements across the revenue cycle.
• Convert clinical encounter information into accurate, compliant claims while ensuring all required data is complete and correctly submitted.
• Manage claim submissions to payers with accuracy and timeliness to support consistent revenue cycle operations.
• Investigate, resolve, and prevent claim denials, rejections, and billing discrepancies.
• Identify root causes of billing issues across intake, coding, and submission workflows and implement solutions to reduce recurring errors.
• Partner with clinical and administrative teams to maintain clean data throughout the patient care and billing journey.
• Ensure compliance with payer requirements, healthcare regulations, and internal billing standards.
• Support continuous improvement initiatives that enhance revenue cycle performance and operational outcomes.

Requirements

• Experienced medical billing professional with strong knowledge of healthcare claims processes, payer requirements, and revenue cycle operations.
• Highly organized, analytical, and comfortable managing high-volume workflows while maintaining exceptional accuracy.
• 5+ years of medical billing experience, preferably within primary care or managed care environments.
• Hands-on experience with electronic medical record and billing systems such as eCW, Epic, or similar platforms.
• Experience working with clearinghouses such as Waystar, AdvancedMD, or comparable solutions.
• Knowledge of HMO/PPO workflows, payer rules, and reimbursement requirements.
• Understanding of physician billing processes within primary care settings preferred.
• Experience with value-based care billing models, including capitation workflows, is a plus.
• Familiarity with CPT II codes and HEDIS reporting requirements is preferred.
• Strong analytical skills with the ability to identify trends, investigate issues, and improve processes.
• Exceptional attention to detail and ability to maintain accuracy in a high-volume environment.
• Strong ownership mindset with the ability to proactively solve problems rather than simply process transactions.
• Ability to collaborate effectively with clinical, operational, and administrative teams.

Benefits

• Remote work opportunity within the United States, with preference for candidates located in Eastern or Central time zones.
• Competitive compensation of $21-$23 per hour based on experience and qualifications.
• Generous annual performance bonus opportunity.
• Health, dental, and vision insurance coverage.
• Paid time off.
• 401(k) retirement plan with company match.
• Opportunity to contribute to a mission-driven healthcare organization improving care delivery for seniors.
• Career growth opportunities within a rapidly expanding healthcare environment.
• Collaborative culture focused on accountability, teamwork, excellence, and continuous improvement.