Medical Billing & Claims Specialist

Job Title: Medical Billing & Claims Specialist
Position type: Full-Time

Work hours: 8:00 AM to 5:00 PM Central Daylight Time (final schedule might change)
Work days: Monday to Friday
Salary: $5 - $7 per hour, depending on experience
Workplace: Remote

Our client is a well-established U.S.-based allergy and immunology medical practice seeking an experienced and detail-oriented Medical Billing & Claims Specialist to support its existing in-house billing team.

This role is primarily focused on c laims posting, claims management, denial management, and billing support. You will work with a steady volume of medical claims and help ensure they are processed accurately, efficiently, and in compliance with established billing procedures.

The ideal candidate has at least 2–3 years of hands-on medical billing experience , with strong experience in both claims posting and claims management for medical procedures . You should be comfortable investigating denied claims, handling complex billing scenarios, and following claims through resolution and payment.

Training will be provided for the practice's systems, ModuleMD and RXNT , so candidates with strong medical billing experience using other platforms are also encouraged to apply.
Key Responsibilities
Claims Posting & Management

- Post and process medical claims accurately and efficiently

- Manage claims related to medical procedures from submission through resolution

- Review claims for completeness and accuracy before processing

- Maintain accurate posting and billing records

- Manage a consistent daily volume of claims while maintaining quality and accuracy

- Track claim status and follow up on outstanding claims

- Help ensure claims are processed according to established billing and compliance requirements

Denial Management & Follow-Up

- Review and work denied or rejected claims

- Identify reasons for denials and take appropriate corrective action

- Resubmit or follow up on claims as necessary

- Work toward successful claim overturns and reimbursement

- Document denial actions and claim follow-up accurately

- Identify recurring billing or denial issues when appropriate

Medical Billing Support

- Provide billing support to the existing in-house billing team

- Assist with complex billing scenarios, including situations involving multiple patient reimbursements

- Review payer information and billing documentation as needed

- Maintain organized and accurate billing records

- Follow established compliance and confidentiality requirements

- Assist with additional billing-related responsibilities as assigned

Performance Expectations

Performance will be evaluated based on factors such as:

- Number of claims accurately processed and posted

- Accuracy of claims posting

- Productivity and ability to manage the expected daily claims volume

- Number and percentage of denied claims successfully overturned or paid

- Quality and accuracy of billing documentation

- Consistency in meeting established claims-processing goals

The practice is targeting strong productivity in claims processing, with an expectation of working toward at least 80 claims posted per day and approximately 85–90% successful resolution/payment of worked claims , where applicable.
Requirements
Required Skills & Experience

- Minimum 2–3 years of medical billing experience

- Hands-on claims posting experience is required

- Strong experience managing claims for medical procedures is required

- Experience working denied and rejected claims through resolution

- Strong understanding of the medical billing and claims lifecycle

- Ability to investigate claim issues and determine appropriate next steps

- Experience handling complex billing scenarios

- Strong understanding of billing accuracy, compliance, and confidentiality requirements

- Ability to manage a high volume of claims while maintaining accuracy

- Strong attention to detail and organizational skills

- Able to work indep