Remote Medical Billing Specialist
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What you'll do
- Review EOBs and ERAs to identify non-payment and denial reasons.
- Analyze and resolve claim denials and rejections.
- Review claims for proper diagnosis and procedure code linkage.
- Apply appropriate billing modifiers.
- Perform claims scrubbing and quality checks before submission.
- Manage claim queues and follow-up workflows.
- Submit initial and secondary claims according to payer guidelines.
- Research payer portals and insurance websites for claim updates and resolution.
- Follow up on unpaid and rejected claims.
- Maintain accurate billing records, documentation, and account notes.
- Support client accounts and respond to billing-related questions.
- Communicate professionally with insurance companies, clients, patients, and provider offices when required.
What they're looking for
- 3+ years of U.S. medical billing / Revenue Cycle Management (RCM) experience.
- Strong hands-on experience across medical billing and revenue cycle workflows.
- Experience with claims processing, denial management, claims follow-up and collections.
- Ability to read and interpret EOBs and ERAs.
- Experience reviewing diagnosis and procedure code relationships.
- Knowledge of billing modifiers and claims scrubbing.
- Experience using insurance payer portals and billing systems.
- Strong organizational, analytical, and problem-solving skills.
- Strong written and verbal English communication.
- Ability to work independently with minimal supervision.
Nice to have
- Experience in high-volume medical billing environments.
- OBGYN medical billing experience strongly preferred.
- Experience with insurance verification and account management.
- Previous remote work experience.
- eClinicalWorks (eCW)
- Aprima
- Medisoft
- Veradigm
Summarised by NextRaise from the employer’s description, which follows in full below.
Full description from employer
Position Type: Full-Time, Remote
Working Hours: U.S. Business Hours
About the Role
We are looking for an experienced Medical Billing Account Manager to support our Revenue Cycle Management (RCM) operations. This role is ideal for someone with strong hands-on U.S. medical billing experience who can independently manage claims, denials, follow-ups, collections and account management.
The ideal candidate is organized, detail-oriented, comfortable working independently and able to quickly adapt to established billing workflows.
Key Responsibilities
Medical Billing & RCM
- Review EOBs and ERAs to identify non-payment and denial reasons.
- Analyze and resolve claim denials and rejections.
- Review claims for proper diagnosis and procedure code linkage.
- Apply appropriate billing modifiers.
- Perform claims scrubbing and quality checks before submission.
- Manage claim queues and follow-up workflows.
- Submit initial and secondary claims according to payer guidelines.
- Research payer portals and insurance websites for claim updates and resolution.
- Follow up on unpaid and rejected claims.
- Maintain accurate billing records, documentation, and account notes.
Account Management
- Support client accounts and respond to billing-related questions.
- Communicate professionally with insurance companies, clients, patients, and provider offices when required.
- Support collections and ensure timely resolution of outstanding accounts.
- Meet productivity, quality, and turnaround-time expectations.
- Work independently with minimal supervision.
Required Experience & Skills
Must-Have
- 3+ years of U.S. medical billing / Revenue Cycle Management (RCM) experience.
- Strong hands-on experience across medical billing and revenue cycle workflows.
- Experience with claims processing, denial management, claims follow-up and collections.
- Ability to read and interpret EOBs and ERAs.
- Experience reviewing diagnosis and procedure code relationships.
- Knowledge of billing modifiers and claims scrubbing.
- Experience using insurance payer portals and billing systems.
- Strong organizational, analytical, and problem-solving skills.
- Strong written and verbal English communication.
- Ability to work independently with minimal supervision.
Preferred
- Experience in high-volume medical billing environments.
- OBGYN medical billing experience strongly preferred.
- Experience with insurance verification and account management.
- Previous remote work experience.
EHR / Practice Management Systems
Experience with one or more of the following is a plus:
- eClinicalWorks (eCW)
- Aprima
- Medisoft
- Veradigm
- Nextech
- CureMD
- Office Practicum
- NextGen
Technical & Remote Work Requirements
Computer
- Windows 10 or Windows 11
- Intel i5 / Ryzen 5 or equivalent minimum
- 16 GB RAM recommended
- 256 GB SSD minimum
- Dual monitors preferred
Internet
- Ping/latency: Under 50 ms
- Download speed: 100+ Mbps
- Upload speed: 100+ Mbps
- Fiber internet with wired Ethernet/LAN preferred
Workspace
- Noise-canceling headset required
- Webcam required
- Quiet and professional workspace required
- Backup internet connection preferred
What Makes You a Strong Fit
- You have 3+ years of hands-on U.S. medical billing/RCM experience.
- You are confident handling claims, denials, EOBs/ERAs, payer follow-ups, and collections.
- You have experience working with medical billing/EHR systems.
- You can manage a high volume of work while maintaining accuracy.
- You communicate professionally with payers, clients, and healthcare offices.
- You can quickly adapt to established workflows and work independently.
- OBGYN and eClinicalWorks experience will be a strong advantage.
Typical Day
You will spend your day reviewing claims and EOBs/ERAs, resolving denials and rejections, following up with insurance carriers, managing claim queues, researching payer requirements, updating billing records, and supporting assigned client accounts. Success in this role means maintaining billing accuracy, resolving claims efficiently, improving collections, and consistently meeting productivity and quality expectations.
Interview Process
- SparkHire Video Interview
- Initial Screening
- Client Interview
- Offer Stage
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Company
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