Role Description
We are seeking a reliable, detail-oriented, and experienced Medical Billing Specialist (Primary Care) to support accurate claims processing, timely reimbursement, and efficient revenue cycle operations.
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Take ownership of assigned medical billing responsibilities, including claims submission, insurance follow-ups, denial and rejection management, accounts receivable (AR), and billing-related documentation reviews.
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Identify potential reimbursement risks, resolve outstanding claims, and maintain accurate reporting to support a smooth transition to an in-house billing process.
Qualifications
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At least 1 year of hands-on U.S. medical billing experience.
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Solid understanding of medical coding concepts and payer requirements.
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Ability to independently manage billing tasks with accuracy and accountability.
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Experience in primary care and/or behavioral health billing is highly preferred.
Requirements
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Prepare, review, submit, and track medical claims accurately and within payer filing deadlines.
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Apply knowledge of ICD-10, CPT, HCPCS, and Evaluation & Management (E/M) billing concepts to identify potential claim errors and documentation gaps.
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Investigate pending, rejected, denied, downcoded, or unpaid claims and determine appropriate next steps.
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Process claim corrections, resubmissions, reconsiderations, and appeals as needed.
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Follow up with insurance payers to resolve outstanding claims and reimbursement issues.
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Identify unfiled claims, approaching filing deadlines, and billing backlogs.
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Maintain accurate records of submitted, pending, corrected, and resolved claims.
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Verify patient insurance information, eligibility, and coverage when needed.
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Manage assigned accounts receivable (AR) and follow up on outstanding balances.
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Resolve payer denials, rejections, and downcoding issues through appropriate corrections and appeals.
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Review billing-related clinical documentation to ensure completeness and alignment with submitted claims.
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Maintain accurate daily progress reports detailing claims submitted, pending tasks, follow-ups, and unresolved issues.
Benefits
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Access to world-class support for questions, guidance, contract matters, and client communication.
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Access to our internal HIPAA compliance training, cybersecurity modules, and certification.
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Access to our proprietary training on communication, client management, productivity systems, and best practices.
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Contractors may take U.S. holidays off according to the clientβs needs and schedule.
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Time off may be granted by your client, with paid time off being optional and only if offered by the client.
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Access to templates, workflow guides, productivity tools, and client-specific SOP support.
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Optional performance-based incentives may be available based on your performance.