Medical Billing and Coding Specialist (Remote)

We are looking for a detail-oriented, knowledgeable Medical Billing & Coding Specialist to join our team and support our healthcare client engagements. In this role, you will assign accurate medical codes (ICD-10-CM, CPT, HCPCS), process and submit clean claims to insurance payers, follow up on denials and rejections, and ensure compliance with healthcare regulations. If you have experience in medical billing and coding, a strong understanding of payer requirements, and take pride in accuracy and revenue cycle performance, this fully remote role offers the opportunity to make a meaningful impact.

Key Responsibilities

• Assign accurate ICD-10-CM, CPT, and HCPCS codes for diagnoses, procedures, and services based on clinical documentation.
• Review and interpret physician notes, operative reports, and other medical records to ensure coding accuracy.
• Ensure coding compliance with CMS, AMA, and payer-specific guidelines.
• Prepare, review, and submit clean claims to commercial insurance, Medicare, Medicaid, and other third-party payers.
• Verify patient insurance eligibility, benefits, and authorization requirements prior to claim submission.
• Post payments, adjustments, and denials accurately within the billing system.
• Analyze and appeal denied or underpaid claims, resubmitting corrected claims as needed.
• Ensure all billing and coding practices comply with federal and state regulations.
• Respond to patient billing inquiries and resolve disputes professionally.
• Provide coding and billing support to healthcare providers and administrative staff.

Requirements

• Previous experience in medical billing, medical coding, revenue cycle management, or related healthcare role is preferred.
• Associate's or Bachelor's degree in Health Information Management, Medical Coding, or related field is preferred.
• Active certification such as CPC (Certified Professional Coder, CCS (Certified Coding Specialist), CRC, CIC, or AHIMA credential is preferred.
• Proficiency in ICD-10-CM, CPT, HCPCS Level II, and medical terminology.
• Experience with practice management systems, EHR/EMR platforms (Epic, Cerner, Allscripts, Next Gen, or similar), and billing software.
• Familiarity with commercial payers, Medicare, Medicaid, and denial management processes.
• Solid understanding of HIPAA, CMS guidelines, and medical coding ethics.
• Impeccable accuracy with the ability to spot coding errors and billing discrepancies.
• Strong problem-solving skills with the ability to research and resolve claim denials.
• Clear written and verbal communication skills with the ability to explain billing and coding issues to providers, patients, and payers.
• Strong time management skills with the ability to manage multiple accounts and prioritize follow-up.

Benefits

• Work from anywhere
• Competitive pay
• Flexible schedule
• Supportive and collaborative environment
• Opportunities for growth and advancement

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