Medical Biller

Summary

We are looking for a detail-oriented, experienced Medical Biller and Coder to join our in-house remote billing and coding team. This dual-role position is critical for managing the full revenue cycle—from accurate coding of procedures and diagnoses to clean claim submission, AR management, and denial resolution. The ideal candidate must have hands-on experience in both billing and coding within specialty care and be comfortable working in a fast-paced, procedure-heavy environment.

Compensation

₹45,000 to ₹70,000 per month (based on experience and specialty expertise)

Key ResponsibilitiesMedical Coding & Compliance

• Accurately assign CPT, ICD-10, and HCPCS codes based on provider documentation.
• Ensure coding aligns with specialty-specific payer guidelines and documentation requirements.
• Collaborate with billing and clinical teams to resolve coding-related queries or discrepancies.
• Maintain up-to-date knowledge of coding standards, modifiers, NCCI edits, and payer-specific rules.

Specialty Care Expertise

• Code and bill for procedures and services in two or more of the following specialties:
• Cardiology
• Pulmonary
• Sleep Medicine
• ENT
• Gastroenterology (GI)
• Neurology
• Internal Medicine (only if procedure-heavy practice)
• Chronic Care Management (CCM) / Remote Patient Monitoring (RPM)
• Rheumatology (only if experience is from a procedure-heavy setting)

Please Note:

Absolutely not considering candidates with experience limited to:

• Only Infectious Disease or Nephrology
• Only Mental Health
• Only General Surgery without specialty-specific exposure

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.

Denial Prevention & Revenue Optimization

• Identify and address coding-related issues that may result in denials or delays in reimbursement.
• Proactively support clean claim rates through accurate and compliant coding practices.
• Participate in regular audits and provide feedback for continuous improvement.

Documentation Review & Provider Support

• Review clinical documentation for completeness and accuracy to support code selection.
• Communicate with providers when clarification or additional documentation is needed.
• Support training and education efforts related to documentation improvement.

Compliance & Documentation

• Maintain up-to-date knowledge of CPT, ICD-10, and HCPCS codes relevant to specialty 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 5 years of US medical billing and coding experience, specifically in specialty care.
• Must have coded and billed for at least two of the specified specialties listed above.
• Strong working knowledge of CPT, ICD-10, and HCPCS codes.
• Familiarity with payer-specific coding and billing rules, insurance guidelines, and compliance standards.
• Experience in AR follow-ups, denial resolution, collections, and reimbursement optimization.
• Proficiency in medical billing software and Electronic Health Records (EHR).
• Excellent analytical and problem-solving skills.
• High attention to detail and commitment to accuracy and compliance.
• Strong communication skills for cross-team collaboration, provider engagement, and patient interactions.
• Ability to work independently and meet deadlines in a remote environment.

Schedule & Work Environment

• Full-time, remote position.
• Must be able to work in alignment with US business hours.
• Availability is required for team meetings, training sessions, and performance reviews.
• Stable internet, reliable electricity, proper work tools, and a quiet workspace are essential.

Job Type: Full-time

Pay: ₹45, ₹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?

Experience:

• US Medical Billing & Coding: 5 years (Required)

Work Location: Remote