Senior Medical Billing Specialist (Primary Care)

New

Preferred Candidate Location: Philippines, 9:00 AM to 6:00 PM Eastern Time, Monday to FridayContractSenior

Salary7 - 8 USD per hour

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Job Details

Languages: Must be proficient in speaking and writing clear, professional English.
Experience: At least 3 years of proven, hands-on U.S. medical billing experience (mandatory).
Required Skills: HIPAA

Have at least 3 years of hands-on U.S. medical billing experience.
Have extensive experience in U.S. primary care medical billing.
Have previous experience leading, managing, or supervising a medical billing team.
Know primary care diagnoses, billing workflows, reimbursement processes, and payer-specific requirements.
Have advanced working knowledge of ICD-10, CPT, HCPCS, and E/M billing guidelines.
Have experience preparing, reviewing, submitting, and tracking electronic medical claims.
Have experience with accounts receivable, denials, rejections, downcoding, insurance appeals, and payer follow-ups.
Understand revenue cycle management, collections, clinical documentation requirements, and HIPAA.
Be proficient with EHR/EMR systems, practice management software, medical billing platforms, claims submission systems, clearinghouses, and insurance portals.
Be proficient in speaking and writing clear, professional English.
Be available full-time, Monday through Friday, from 9:00 AM to 6:00 PM Eastern Time, including video meetings with camera on when required.
Submit an NBI Clearance and/or Local Police Clearance before onboarding.
Have a reliable computer, stable high-speed internet of at least 25 Mbps, a noise-canceling headset, a working webcam, and a quiet professional workspace.

Prepare, review, submit, and track claims for multiple U.S. primary care providers within payer filing deadlines.
Apply ICD-10, CPT, HCPCS, and E/M billing concepts to identify coding errors, discrepancies, and documentation gaps.
Investigate denied, rejected, pending, downcoded, or unpaid claims and oversee corrections, resubmissions, appeals, and follow-ups.
Oversee accounts receivable, outstanding balances, underpayments, payment discrepancies, and insurance follow-ups.
Review clinical documentation for support of billed diagnoses, procedures, and services, and coordinate corrections with providers and staff.
Monitor payer requirements and policy changes, conduct billing quality and compliance checks, and escalate potential risks.
Manage medical billing associates by assigning work, monitoring performance, and verifying claim statuses and completed work.
Develop and update SOPs, training materials, onboarding guides, performance expectations, and accountability checks.
Prepare progress reports, backlog summaries, follow-up plans, and departmental performance records.
Collaborate with providers, management, and internal staff to improve billing workflows and revenue cycle operations.

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