Medical Billing Specialist
Accountabilities: The Medical Billing Specialist will oversee end-to-end billing activities, ensuring claims are accurate, compliant, and processed efficiently. This role requires 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.
Work across billing and healthcare platforms to manage claims, analyze data, and monitor performance.
Generate reports and queries to identify trends, opportunities, and areas requiring improvement.
Audit billing workflows and recommend process enhancements that improve accuracy, efficiency, and compliance.
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:
The ideal candidate is an experienced medical billing professional with strong knowledge of healthcare claims processes, payer requirements, and revenue cycle operations. You should be 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.
Strong understanding of encounter data, claims workflows, and end-to-end revenue cycle processes.
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.
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?
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