The posting
[Kindly submit your updated English resume]
We are seeking a highly skilled Full-Cycle Medical Biller with extensive experience in U.S. healthcare billing, particularly within California insurance systems. This role requires a deep understanding of the end-to-end billing cycle, including claim submission, payment posting, accounts receivable (A/R), and denial management.
The ideal candidate is a proactive problem-solver who can independently navigate complex payer systems while also supporting front-office functions, including patient intake and communication.
Key Responsibilities:
- Manage the full-cycle medical billing process from claim creation to final payment resolution
- Perform accurate claim submission and generation using ICD-10 and CPT coding
- Handle payment posting, reconciliation, and adjustments
- Monitor and manage Accounts Receivable (A/R) to ensure timely collections
- Conduct denial management and follow-ups, including appeals and resubmissions
- Perform insurance verification and eligibility checks
- Process and manage prior authorizations for procedures and services
- Navigate payer portals (e.g., Availity and payer-specific systems) for claims, eligibility, and follow-ups
- Communicate with insurance providers regarding claim status, denials, and authorizations
- Support front-office operations, including patient intake and insurance-related inquiries
- Ensure compliance with medical necessity documentation and payer requirements
- Collaborate with providers and internal teams to resolve billing discrepancies
Requirements
- 2+ years of end-to-end medical billing experience (REQUIRED)
- Strong proficiency in:
- Claim submission and generation
- ICD-10 and CPT coding
- Payment posting
- A/R management
- Denial handling and follow-ups
- Extensive experience with:
- Insurance verification and prior authorizations (REQUIRED)
- Hands-on experience working with:
- Medicare
- Medicaid / Medi-Cal (or state equivalent)
- Medicare Advantage plans
- HMO plans in California (REQUIRED)
- Deep familiarity with U.S. insurance portals (e.g., Availity, payer portals)
- Strong understanding of medical necessity requirements
- Excellent communication and problem-solving skills
- Willingness to work in US time zones (PST, EST, CST).
- High school diploma or equivalent.
Preferred Qualifications
- Experience working with Independent Physician Associations (IPAs)
- Background in Primary Care and/or ENT (Ear, Nose, and Throat) specialties
- Experience with DrChrono EHR (preferred but not required)
System and Work Setup Requirements:
- Internet: Minimum speed of 25 Mbps or higher, with a reliable backup connection available in case of power outages or service provider issues.
- Processor: Intel Core i5 7th Generation or higher (or equivalent).
- Memory: 8 GB RAM.
- Storage: 256 GB SSD or HDD with at least 50% free space available.
- Webcam: 720p resolution or higher.
- Operating System: Windows 10 or later (or equivalent).
- Audio Equipment: Noise-canceling earphones or headset.
- Workspace: A designated, quiet, and organized workspace free from distractions to ensure productivity and focus.
Benefits
- Permanent remote work setup
- Competitive starting rate paid in USD
- Internet Allowance
- HMO insurance (PH)
- Paid US holidays
- Paid Vacation and Sick Leaves
