**Job Title:** Remote Medical Billing Jobs **Location:** Remote — based in Boone town, North Carolina --- ### About the Role We are seeking an experienced **Remote Medical Billing Specialist** to join our growing revenue‑cycle team. In this role you will *translate clinical documentation into accurate claim submissions*, ensuring our providers in Boone town and across North Carolina receive timely reimbursement. You will work directly with our **Director of Revenue Cycle Management**, collaborating with coding specialists, front‑office staff, and the finance department to close the billing loop from charge entry to payment posting. Our mission is simple: empower healthcare providers in Boone town to focus on patient care while we handle the complex, ever‑changing landscape of insurance rules, compliance, and payer contracts. --- ### Key Responsibilities - **Claim Submission & Follow‑Up:** Generate, review, and submit >12,000 electronic claims per month using **Epic** and **Kareo**, maintaining a 98% clean claim rate. - **Denial Management:** Investigate and resolve an average of 150 denied claims weekly, applying root‑cause analysis and appealing to insurers within required windows. - **Coding Accuracy:** Perform ICD‑10‑CM, CPT, and HCPCS coding verification for each encounter, acting as a **healthcare coder** mentor to junior staff. - **Revenue Reporting:** Build weekly dashboards in **Microsoft Power BI** and **Excel** that track key performance indicators (KPIs) such as days in A/R, collection rate, and net revenue. - **Payer Contracts:** Keep an up‑to‑date repository of fee schedules and contractual adjustments for the top 30 payers in North Carolina, leveraging **Salesforce** for contract management. - **Compliance Audits:** Conduct monthly internal audits using **AdvancedMD** audit tools to ensure HIPAA and OIG compliance, preparing reports for senior leadership. - **Collaboration:** Partner with the **coding specialist** team via **Slack** and **Zoom** to clarify documentation gaps and educate providers on best‑practice documentation. - **Process Improvement:** Lead at least two process‑optimization projects per year, employing **Jira** to track workflow enhancements and measure ROI. - **Training & Onboarding:** Facilitate virtual onboarding for new billing specialists, delivering a 4‑hour curriculum covering claim lifecycle, software navigation, and compliance basics. - **Patient Billing Queries:** Respond to patient billing inquiries within a 48‑hour SLA, using **Cerner** billing portal to provide transparent explanations of charges. --- ### Required Qualifications - Associate’s degree in Health Information Management, Business Administration, or related field *or* equivalent work experience. - **3–5 years** of full‑cycle medical billing experience in a physician‑practice or hospital setting. - Proven expertise as a **billing specialist** and **coding specialist**, with at least **2 years** of hands‑on ICD‑10‑CM/CPT coding. - Proficiency with **Epic**, **Kareo**, **AdvancedMD**, **Cerner**, **Microsoft Office 365** (especially Excel), **Slack**, **Zoom**, and **Jira**. - Demonstrated ability to achieve a **≥95% clean claim rate** and reduce denial percentages by **15%+** year‑over‑year. - Strong analytical skills; comfortable interpreting payer guidelines, fee schedules, and reimbursement methodologies. - Excellent written and verbal communication; must be able to convey complex billing concepts to clinicians and patients alike. - Reliable high‑speed internet (minimum 25 Mbps download, 5 Mbps upload) and a dedicated home office space meeting **ERG (Ergonomic) standards**. --- ### Preferred Qualifications - Certified Professional Biller (**CPB**) or Certified Coding Specialist (**CCS**) credential. - Experience with **Health Level Seven (HL7)** interface engines and **EDI** transaction sets. - Prior work in a **telehealth** or fully remote billing environment serving multiple states, especially within North Carolina. - Demonstrated leadership in training or supervising a team of 5+ billing professionals. - Familiarity with **Revenue Cycle Management (RCM) analytics platforms** such as **Athenahealth** or **Rite Aid**. - Ability to speak Spanish or another language spoken by our patient population in Boone town. --- ### Compensation & Benefits - **Salary:** $55,000 – $70,000 annually, commensurate with experience and certifications. - **Performance Bonus:** Up to 10% of base salary based on clean‑claim rate, denial reduction, and collection targets. - **Health & Wellness:** Medical, dental, vision, and $1,200 annual health‑care stipend for employees in North Carolina. - **Retirement:** 401(k) with 4% company match. - **Paid Time Off:** 15 days PTO + 10 paid holidays (including State holidays observed in North Carolina). - **Remote Work Stipend:** $150/month for home‑office equipment, high‑speed internet, and coworking‑space access in Boone town. - **Professional Development:** $2,000 annual learning