Remote Medical Billing Specialist

AAPC; Saginaw (MI); Hybrid; USD 42,000 - 64,000; Full time

Benefits offered by this job

Remote work option

Job summary

AAPC is seeking a detail-oriented Medical Billing Specialist to manage claims submission, coding, and payer communications. The role requires accuracy in ICD-10, CPT, and HCPCS, and familiarity with EHR/EMR systems.

You will generate cost estimates, review data for accuracy, resolve denials, and assist patients with billing questions while ensuring HIPAA compliance. This position offers flexible work-from-home options depending on experience.

Qualifications

• High school diploma required; associate degree preferred.
• CPC or CCS certification strongly preferred.
• Minimum 2 years in medical billing, coding, and insurance follow-up.
• Strong knowledge of ICD-10, CPT, HCPCS coding.
• Proficiency with EHR/EMR systems and billing software.

Responsibilities

• Process and submit medical claims to insurers and government payers.
• Code procedures and diagnoses using ICD-10, CPT, HCPCS.
• Generate cost estimates based on coverage and contracts.
• Review billing data in EHR/EMR before submission.
• Resolve billing discrepancies and denials; prepare appeals.
• Communicate with patients about billing and coverage.
• Maintain HIPAA compliance and up-to-date payer guidelines.
• Collaborate with clinical staff to ensure accurate documentation.
• Monitor accounts receivable and follow up on outstanding claims.

Skills

Medical billing

Medical coding

HIPAA compliance

Communication skills

Attention to detail

Problem solving

Education

Associate's degree in Healthcare Administration, Billing & Coding

CPC certification

CCS certification

2+ years experience in medical billing

Tools

Epic

Meditech

PrognoCis

EHR/EMR systems

Claims submission software

Job description

We are seeking a detail-oriented and experienced Medical Billing Specialist with a strong background in medical billing, coding, and insurance processes. The ideal candidate will be skilled in medical terminology, procedure coding, cost estimation, insurance appeals, and working within electronic health record systems. This role requires accuracy, excellent communication skills, and the ability to work with both patients and payers to ensure timely and correct reimbursement.

This position may offer the opportunity to work from home, depending on experience and performance.

Key Responsibilities:

• Accurately process and submit medical claims to insurance companies, government payers, and other third-party organizations.
• Perform medical coding using ICD-10, CPT, and HCPCS standards for a variety of procedures and diagnoses.
• Generate and communicate cost estimates for procedures based on insurance coverage and contract agreements.
• Review and verify accuracy of billing data within EHR/EMR systems prior to claim submission.
• Utilize EHR/EMR platforms (such as Epic, Meditech, PrognoCis) for documentation, coding, and billing workflows.
• Research and resolve billing discrepancies or claim denials.
• Prepare and submit insurance appeals, ensuring compliance with payer guidelines.
• Communicate with patients regarding billing questions, payment responsibilities, and insurance coverage.
• Maintain up-to-date knowledge of medical terminology, payer requirements, and compliance regulations (HIPAA, CMS, etc.).
• Collaborate with clinical staff and providers to ensure accurate coding and documentation within electronic systems.
• Track accounts receivable and follow up on outstanding claims to maximize revenue.

Requirements

Qualifications:

• High school diploma or equivalent required; Associate's degree in Healthcare Administration, Billing & Coding, or related field preferred.
• Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent certification strongly preferred.
• Minimum of 2 years of experience in medical billing, coding, insurance follow-up, and working within EHR/EMR systems.
• Strong knowledge of ICD-10, CPT, and HCPCS coding systems.
• Hands-on experience with electronic health record (EHR) and electronic medical record (EMR) systems, including Epic, Meditech and/or PrognoCis.
• Familiarity with medical terminology, payer reimbursement guidelines, and healthcare regulations.
• Experience creating cost estimates for medical procedures.
• Skilled in preparing and submitting appeals for denied claims.
• Proficiency with medical billing software and electronic health record (EHR) systems.
• Strong attention to detail, problem-solving, and organizational skills.
• Excellent written and verbal communication skills.

Preferred Skills:

• Experience with Medicare/Medicaid billing and commercial insurance.
• Advanced knowledge of EHR/EMR workflows and system navigation.
• Ability to work independently and manage multiple tasks in a fast-paced environment.
• Customer service experience in a healthcare setting.