Medical Billing Specialist - Practice Fusion

This is a remote position.

Job SummaryRCM Staff BPO is hiring a full-time Medical Billing Specialist to support a medical billing company based in Texas.The specialist owns the day-to-day billing cycle for one provider account: scrubbing and submitting claims, posting ERA and paper EOB payments, working denials and rejections, following up on outstanding claims, and preparing weekly and monthly billing reports for the client's management team. This role has no direct contact with the end practice, so all reporting and coordination goes through the client's management. This role requires solid end-to-end U.S. medical billing experience, strong attention to detail, consistent follow-up, and experience working with U.S. health insurance plans.

Key Responsibilities

Scrub claims in the practice management system before submission and correct errors that would cause a rejection

Submit clean claims to the clearinghouse, then correct and resubmit any claims that are rejected

Post payments from ERAs and from scanned paper EOBs, attaching each scanned EOB to the patient ledger

Work claim denials: identify the cause, then correct and resubmit or file an appeal

For denials caused by incorrect insurance, check the Medicare website to identify the patient's Medicare Advantage plan

Follow up on outstanding claims by checking payer websites, and call the insurance company directly when status is not available online

Submit paper claims for patients with tertiary insurance

Verify patient benefits when the client's management team passes along a verification request

Contact the practice management system's support team for clearinghouse issues and payer ID lookups

Run the weekly billed charges report and send it to the client's management team for reconciliation

Compile the monthly accounts receivable (A/R) report and submit it to the client's management team before month end

Provide claim and billing status updates to the client's management team so they can respond to the practice

Protect patient information and follow HIPAA requirements

Qualifications

At least 2 years of experience in U.S. medical billing or claims processing, including claim scrubbing and clearinghouse submission

Experience posting payments from both ERAs and scanned paper EOBs

Experience working claim denials and rejections, including corrected resubmissions and appeals

Working knowledge of Medicare, Medicare Advantage, and coordination of benefits across primary, secondary, and tertiary insurance

Familiarity with commercial insurance and government health plans

Experience using payer portals and insurance websites, and comfortable calling payers by phone for claim status

Able to reconcile two charge reports and identify variances

Strong written and spoken English for internal reporting and coordination

Excellent attention to detail and follow-up skills

Ability to work independently and manage a full account with minimal supervision

Reliable internet connection and a suitable remote workspace

Preferred Qualifications

Experience using Practice Fusion EHR/PM

Experience billing for a behavioral health or outpatient mental health practice

Medical billing certification such as CPB or CMRS

Experience working as a dedicated biller for a U.S. medical billing company or RCM vendor

Familiarity with Texas insurance plans

Schedule

Full-time position

Must be available during Central Time business hours

Final schedule will be determined based on practice needs

Work Arrangement

Remote

Philippines-based applicants preferred

Originally posted on Himalayas