Remote Medical Billing Specialist

CredSpun LLC; United States; Remote; USD 30,000 - 48,000; Full time

Job summary

CredSpun LLC seeks a Remote Medical Billing Specialist to manage the full billing cycle for a small set of outpatient practices. You will work directly in the client’s EHR and clearinghouse, scrub and submit claims, and follow up on denials and unpaid balances.

You’ll perform charge review, posting of ERA/EOBs, and patient communication while documenting every step in the PM system. This role is fully remote within U.S. business hours.

Qualifications

• Two or more years of medical billing experience for U.S. physician or outpatient practices.
• Proficiency with CPT, ICD-10-CM, HCPCS and common modifiers (25, 59, 95, GT).
• Experience with Medicare, Medicaid and commercial payers, including payer portals.
• Comfort reading an EOB/ERA and recognizing CARC and RARC codes.
• Clear written English for claim notes, appeals and patient messages.
• Accuracy under deadline and the habit of documenting what you did.

Responsibilities

• Review charges for completeness and match CPT, HCPCS, ICD-10-CM codes and modifiers to the visit.
• Scrub and submit professional claims (CMS-1500 / 837P) electronically through the practice's clearinghouse.
• Work clearinghouse and payer rejections the same day so claims are accepted on first pass.
• Post ERA and paper EOB payments line by line and flag underpayments against the contracted rate.
• Follow up on unpaid claims by portal and phone, and document every touch in the PM system.
• Prepare corrected claims and secondary claims, including Medicare crossovers.
• Answer patient balance questions clearly and set up statements.
• Note recurring errors and pass them to the account lead so they are fixed at the front desk.

Skills

Medical billing

CPT coding

ICD-10-CM

HCPCS codes

Payer portals

Clear English

Attention to detail

Documentation

Tools

EHR systems

Clearinghouse

Athenahealth

eClinicalWorks

Kareo

AdvancedMD

DrChrono

Job description

Own the claim from charge to payment for a small set of outpatient practices — scrubbing, submitting, posting and following up — fully remote, in each practice's own software.

About the medical billing specialist role

Medical billing at CredSpun is not a single step on a production line. Each billing specialist is assigned to a small group of outpatient practices — family medicine, behavioral health, psychiatry, pediatrics, nurse practitioner and specialty clinics — and works their claims across the whole cycle. You know the practice's payer mix, its fee schedule and the denials it tends to see, so problems are caught before a claim goes out rather than after it comes back.

You will work directly in the client's EHR and practice management system and in their clearinghouse. The practice's account lead is your first point of contact, and you will join the fortnightly status calls where we walk the practice through its numbers.

What you will do

• Review charges for completeness and match CPT, HCPCS, ICD-10-CM codes and modifiers to the visit
• Scrub and submit professional claims (CMS-1500 / 837P) electronically through the practice's clearinghouse
• Work clearinghouse and payer rejections the same day so claims are accepted on first pass
• Post ERA and paper EOB payments line by line and flag underpayments against the contracted rate
• Follow up on unpaid claims by portal and phone, and document every touch in the PM system
• Prepare corrected claims and secondary claims, including Medicare crossovers
• Answer patient balance questions clearly and set up statements
• Note recurring errors and pass them to the account lead so they are fixed at the front desk

What you need

• Two or more years of medical billing experience for U.S. physician or outpatient practices
• Working knowledge of CPT, ICD-10-CM, HCPCS and common modifiers (25, 59, 95, GT and the like)
• Experience with Medicare, Medicaid and commercial payers, including payer portals
• Comfort reading an EOB/ERA and recognising CARC and RARC codes
• Clear written English for claim notes, appeals and patient messages
• Accuracy under deadline and the habit of documenting what you did

Helpful, not required

A billing credential such as CPB (AAPC) or CRCR (HFMA); experience in athenahealth, eClinicalWorks, Tebra / Kareo, AdvancedMD, SimplePractice or DrChrono; and some exposure to behavioral health or telehealth billing rules.

Remote Medical Billing Specialist: common questions

Is this medical billing job fully work from home?

Yes. The role is fully remote for applicants living in the United States, working U.S. business hours in each client practice's own systems.

Do I need a certification to apply?

No. Two years of hands-on medical billing experience matters more than a credential. A CPB or CRCR is a plus.