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