Medical Billing Specialist (RCM)
Job Overview
Remote Scouts by Cedar Global Solutions is seeking an experienced Medical Billing Specialist to join our growing team. The ideal candidate will be responsible for managing the medical billing process, ensuring accurate claim submission, timely reimbursement, and compliance with healthcare regulations. This role requires strong attention to detail, excellent analytical skills, and the ability to work independently in a fast-paced healthcare environment.
Key Responsibilities
Process and manage medical claims from submission through payment posting and resolution.
Review patient records, insurance information, and billing documentation for accuracy and completeness.
Submit electronic and paper claims to insurance companies and government payers.
Follow up on unpaid, delayed, denied, or rejected claims to ensure timely reimbursement.
Investigate and resolve billing discrepancies, claim denials, and payment variances.
Verify patient insurance coverage, eligibility, benefits, and authorization requirements as needed.
Post payments, adjustments, and reconcile accounts accurately within billing systems.
Maintain compliance with healthcare regulations, payer guidelines, and company policies.
Communicate effectively with healthcare providers, insurance representatives, and internal teams regarding billing matters.
Generate and maintain billing reports, aging reports, and accounts receivable follow-up documentation.
Required Qualifications
Minimum 3 years of experience in medical billing, revenue cycle management, or a related healthcare billing role.
Strong knowledge of medical billing processes, insurance claims, payment posting, and accounts receivable follow-up.
Proficiency in medical billing software, practice management systems, and Electronic Health Records (EHR/EMR).
Familiarity with ICD-10, CPT, and HCPCS coding concepts.
Knowledge of commercial insurance, Medicare, Medicaid, and other third-party payer requirements.
Strong organizational, analytical, and problem-solving skills with exceptional attention to detail.
Excellent verbal and written communication skills.
Ability to work independently, prioritize tasks, and meet deadlines in a remote environment.
Understanding of HIPAA regulations and healthcare compliance standards.
Preferred Qualifications
Experience working with multiple medical specialties and healthcare practices.
Certification in medical billing or revenue cycle management is a plus.
Experience with denial management, appeals, and insurance verification.
Advanced proficiency in Microsoft Excel and reporting tools.