Job Description

Medical Biller

Full job description
Summary

We are looking for an experienced Medical Biller to join our in-house remote billing team. This role will be responsible for managing the entire revenue cycle, including claim submissions, payment postings, accounts receivable (AR) management, denial management, and patient billing. As we transition from a third-party billing service to an in-house team, the ideal candidate must be proactive, efficient, and experienced in US healthcare billing, particularly in pulmonology, sleep medicine, and primary & urgent care.

MUST HAVE:
Experience in specialty care billing in two or more of the following areas:

Cardiology
Pulmonary
Sleep
ENT
GI
Neurology
Internal Medicine (only if procedure-heavy practice; general internal medicine is not acceptable)
CCM/RPM
Rheumatology (only if worked in a procedure-heavy specialty setting)
Please Note:

Absolutely not, considering candidates with only infectious disease or only nephrology experience.
Absolutely not, considering candidates with only mental health or only surgery billing backgrounds.
Key Responsibilities

Claims Processing & Revenue Cycle Management

Submit accurate and timely claims to insurance companies, including Medicare, Medicaid, and commercial payers.
Review claims for accuracy, ensuring proper coding and compliance with payer guidelines.
Monitor and track submitted claims, identifying and correcting errors before submission.
Work closely with providers and staff to obtain necessary documentation for billing and reimbursement.
Accounts Receivable (AR) & Denial Management

Monitor and manage AR to ensure timely reimbursements from insurance companies and patients.
Follow up on unpaid or underpaid claims, ensuring timely resolution.
Investigate and resolve denied or rejected claims, submitting appeals as necessary.
Identify trends in denials and recommend process improvements to minimize future rejections.
Communicate with payers to clarify coverage, reimbursement rates, and claim status.
Work with the front office and collections team to improve financial recovery and reduce outstanding balances.
Payment Posting & Patient Billing

Post payments from insurance companies and patients into the billing system, ensuring accuracy.
Generate and send patient statements, ensuring clear and transparent billing details.
Follow up on outstanding patient balances through phone calls, emails, and letters.
Assist patients in understanding their bills, insurance coverage, and payment options.
Work with the Front Office team to ensure proper patient collections at the time of service.
Compliance & Documentation

Maintain up-to-date knowledge of CPT, ICD-10, and HCPCS codes relevant to pulmonology, sleep medicine, and primary care.
Ensure billing compliance with HIPAA, CMS, and insurance guidelines.
Keep detailed records of billing activities, correspondence, and account adjustments.
Assist in preparing reports and financial statements related to billing, collections, and AR aging.
Collaboration & Process Improvement

Work closely with Providers, the Front Office, Referral Coordinator, and DME team to ensure accurate charge capture.
Assist in transitioning from the third-party billing service to the in-house team, identifying and resolving process gaps.
Provide feedback and suggestions to improve efficiency and accuracy in billing workflows.
Stay updated on industry trends, policy changes, and payer-specific guidelines.
Qualifications & Skills

Minimum 3 years of US medical billing and AR management experience, preferably in pulmonology, sleep medicine, or primary & urgent care.
Proficiency in medical billing software and Electronic Health Records (EHR).
Strong knowledge of CPT, ICD-10, and HCPCS coding.
Experience with insurance verification, prior authorizations, and denial management.
Expertise in AR follow-ups, collections, and reimbursement optimization.
Excellent analytical skills and attention to detail.
Strong communication skills to interact with insurance companies, patients, and internal teams.
Ability to work independently and meet deadlines in a remote environment.
Stable internet & electricity connection, proper work tools, and a quiet workspace.
Schedule & Work Environment

Full-time, remote position
Work hours aligned with US business hours
Must be available for team meetings, training sessions, and ongoing performance reviews
Job Type: Full-time

Pay: ₹45,000.00 – ₹70,000.00 per month

Benefits:

Paid time off
Work from home
Schedule:

Monday to Friday
Night shift
US shift
Application Question(s):

What is your pay expectation?
Are you available to start immediately? Please provide a potential start date.
Work Location: Remote