Senior Medical Biller

Job Title : Senior Medical Biller

Department : Medica Billing

Location : Remote / India [Currently work from Home]

Experience : 7+ years

Shift Time : 5:30 Pm to 2:30 Am IST

Company Website:

Welcome to ModuleMD

At ModuleMD, we specialize in cloud-based EHR and Practice Management solutions for specialty healthcare providers. Were on a mission to revolutionize revenue cycle management through AI, and were looking for innovators who are ready to help us shape the future.

Our Culture & Values

"We foster a culture of inclusivity, innovation, and integrity. Our team values collaboration, continuous improvement, and a passion for excellence."

Profile Overview

We are seeking a Senior Medical Biller who is responsible for managing the complete medical billing cycle, ensuring accurate claim submissions, denial management, appeals, and compliance with payer regulations. The role requires hands-on experience with insurance portals like CHAMPS, Medicaid, and Medicare, and an in-depth understanding of billing workflows, A/R processes, and medical coding standards.

The ideal candidate will have strong expertise in US Healthcare provider side, in AR Denial Management, including performing root cause analysis, and proven experience in managing billing accounts independently. Since this is a client-facing role, excellent communication and relationship management skills are very essential and MUST.

Role Purpose: What You'll Be Doing

• Perform end-to-end billing and collections for assigned accounts, ensuring claims are submitted accurately and in a timely manner.
• Work extensively on insurance websites such as CHAMPS, Medicaid, and Medicare to verify eligibility, check claim status, and process payments.
• Handle denials management, A/R follow-ups, rejections, and appeals efficiently to maximize reimbursement.
• Prepare and submit Medicare reconsiderations/appeals and understand related procedures such as ABN (Advance Beneficiary Notice), COB (Coordination of Benefits).
• Demonstrate strong working knowledge of what information should be included when filing an appeal for a denied claim.
• Apply accurate ICD-10 and CPT codes, ensuring compliance with payer and coding requirements.
• Review and interpret EOBs (Explanation of Benefits) and Payment Vouchers for payment posting and reconciliation.
• Maintain strict compliance with HIPAA regulations — including privacy, access, and release of information.
• Collaborate with internal teams to resolve complex billing issues and reduce denials.
• Keep updated with payer policy changes and medical billing guidelines.
• Maintain documentation on the client software to support insurance submissions and ensure a clear audit trail for future reference.
• Directly communicate with practices for billing clarifications, documentation, or dispute resolution.
• Post payments accurately as required.
• Conduct Denials Management and A/R follow-ups:
• Analyze accounts receivable data to identify reasons for underpayments and high A/R days.
• Track and document top denial reasons and apply appropriate codes in the billing system — MUST.
• Record after-call actions and complete post-call analysis for claim follow-ups — MUST.
• Comply with all terms of the employment contract, company policies, and procedures.

Must-Have Skills:

• Strong understanding of RCM end and 7+ years of experience in US Healthcare provider side AR and denial management.
• Excellent communication and reporting skills
• Strong analytical skills to interpret data, identify trends, and make informed decisions.
• Hands-on experience with TriZetto's platforms or similar clearinghouse systems (e.g., Waystar, Availity) is highly preferred.
• Knowledge of healthcare compliance standards, including HIPAA and payer-specific regulations and other healthcare compliance standards.

Technical Knowledge:

• Strong skills in Denial management, Payment Posting, AR Follow-up, Appeals with strong Knowledge of the US healthcare industry and RCM.
• Proficiency in computer applications, PMS, Excel, and PPT.
• 7+ years of experience in US Healthcare provider side AR and Denial management.

Required Qualifications

• Education: Bachelor's degree Healthcare Administration, or a related field.
• Minimum of 7 years of experience in revenue cycle management in US Healthcare provider side AR.
• Strong understanding of medical billing, coding, and collections processes.
• Proficiency in RCM software and Microsoft Office Suite.
• Excellent communication and interpersonal skills to interact with clients and payers.
• Proficiency in Microsoft Office (Excel, Word, Outlook).
• Detail-oriented with strong organizational and problem-solving skills.
• Ability to multitask in a fast-paced environment and meet deadlines.

Why Join ModuleMD?

• You'll work at the intersection of AI and healthcare—real-world impact every day.
• Opportunity to work on cutting-edge healthcare technology and onboarding processes.
• Join a tight-knit, mission-driven team that values curiosity, autonomy, and innovation.
• Flexible work environment and a culture of continuous learning.

Application Process:

"Our hiring process includes an initial screening, a technical assessment, and a final interview with the team. We aim to keep the process transparent and timely."

Equal Opportunity Statement: " We are an equal opportunity employer and value diversity at all levels. Discrimination has no place here—we welcome talent from all walks of life".

Ready to Join the Future of Healthcare AI?

Apply now with your GitHub/portfolio link and CV.