Medical Billing Specialist (Claim Submission)

Alpaca Health; United States; Remote; USD 60.000 - 90.000; Vollzeit

Zusammenfassung

Alpaca Health is a remote-first company helping clinicians launch and scale their own clinics. We seek a Billing Specialist to own pre-submission billing accuracy and ensure clean claims are submitted correctly the first time.

You will resolve coding issues, review EHR data for accuracy, and coordinate with clinical and operations teams to prevent denials and drive revenue cycle efficiency.

Qualifikationen

• Bachelor's degree or equivalent experience.
• Excellent attention to detail and organizational skills.
• 2–3 years of healthcare billing or revenue cycle experience.
• Strong understanding of medical billing workflows, claim submission, and coding fundamentals.
• Experience with EHR systems, clearinghouses, and billing platforms.
• Familiarity with commercial and government insurance requirements.
• Strong communication and problem-solving abilities.
• Comfortable working cross-functionally with clinical and operational teams.
• Proficient in MS Office and business systems.
• Ability to manage multiple priorities and meet deadlines in a fast-paced environment.

Aufgaben

• Review claims before submission to identify coding, demographic, and documentation issues.
• Own pre-submission billing edits and claim scrubbing workflows.
• Resolve CPT modifiers, diagnosis mismatches, and authorization discrepancies.
• Review EHR data for demographic accuracy, insurance, and provider setup.
• Identify and correct missing or inaccurate patient, provider, or authorization data.
• Coordinate with clinical, intake, credentialing, and operations teams to resolve blockers.
• Monitor clearinghouse rejections and ensure timely corrections.
• Maintain accurate billing records and claim documentation.
• Support process improvements to reduce denials and raise clean claim rates.
• Assist with payer and clearinghouse communications via portal, fax, phone, and email.

Kenntnisse

Attention to detail

Organizational skills

Cross-functional collaboration

Communication skills

Problem solving

Time management

Ausbildung

Bachelor's degree or equivalent experience

Tools

EHR systems

Billing platforms

MS Office

Payer portals

Jobbeschreibung

Alpaca Health

Alpaca Health enables clinicians to become entrepreneurs, starting in autism care.

We help clinicians launch and scale their own clinics by providing AI-powered software, payer contracting, and full back-office infrastructure. Our goal is simple: shift power in healthcare away from large consolidated entities and back to clinicians.

This role is remote. We're looking for candidates based outside of the United States, but able to work United States East Coast time zones.

What You'll Do

We are looking for a detail-oriented Billing Specialist to own pre-submission billing accuracy and ensure clean claims are submitted correctly the first time. This role focuses on resolving coding issues, identifying EHR and demographic inaccuracies, and preventing downstream denials and rework. Specifically, this role will:

• Review claims prior to submission to identify coding, demographic, and documentation issues
• Own pre-submission billing edits and claim scrubbing workflows
• Resolve coding-related issues including CPT modifiers, diagnosis mismatches, and authorization discrepancies
• Review EHR data for demographic accuracy, insurance information, rendering provider setup, and payer requirements
• Identify and correct missing or inaccurate patient, provider, or authorization data before claims submission
• Coordinate with clinical, intake, credentialing, and operations teams to resolve billing blockers
• Monitor clearinghouse rejections and ensure timely corrections and resubmissions
• Maintain accurate billing records and claim documentation
• Support process improvement initiatives to reduce preventable denials and increase clean claim rates
• Assist with payer and clearinghouse communication via portal, fax, phone, and email
• Track recurring claim issues and track systemic problems proactively

Who You Are

• Bachelor's degree or equivalent experience
• Excellent attention to detail and organizational skills
• At least 2–3 years of experience in healthcare billing or revenue cycle operations
• Strong understanding of medical billing workflows, claim submission, and coding fundamentals
• Experience working with EHR systems, clearinghouses, and billing platforms
• Familiarity with commercial and government insurance requirements
• Strong communication and problem-solving abilities
• Comfortable working cross-functionally with clinical and operational teams
• Proficient in MS Office and business systems
• Ability to manage multiple priorities and meet deadlines in a fast-paced environment