The role involves managing the full medical billing cycle, including coding encounters, submitting claims, and handling denials and appeals. You will also be responsible for documenting account activity and ensuring compliance with HIPAA regulations.
This is a remote position.
Job Summary
RCM Staff BPO is hiring full-time AAPC-Certified Medical Billers and Coders to support U.S. medical billing companies and physician practices.
You will own insurance claims from start to finish. That means coding encounters, creating and submitting claims, following up on unpaid claims, working denials and appeals, and keeping every account clearly documented. This role requires an active AAPC certification, strong attention to detail, consistent follow-up, and experience working with U.S. health insurance plans.
Key Responsibilities
Review assigned accounts, new denials, payer correspondence and scheduled follow-ups each day, prioritizing filing deadlines, older claims and high-dollar balances
Assign CPT, ICD-10-CM and HCPCS codes and modifiers from provider documentation
Complete charge entry and submit clean claims through the clearinghouse
Follow up on unpaid claims through payer portals and phone calls, obtaining reference numbers and expected resolution dates
Identify the cause of denials and rejections, then submit corrected claims, reconsiderations and appeals before deadlines
Submit requested medical records securely and keep proof of submission
Review payments and balances for underpayments, posting errors and secondary insurance before transferring patient responsibility
Document every account with the issue, action taken, payer response, reference number and next follow-up date
Escalate unresolved accounts, approaching deadlines and recurring denial patterns to the billing team
Protect patient information and follow HIPAA requirements
Qualifications
Active AAPC certification (CPB, CPC or COC); a copy of your certificate is required to be considered
At least 2 years of experience with U.S. healthcare insurance billing and A/R follow-up
Hands-on experience with denials, appeals, EOBs, ERAs and timely filing requirements
Familiarity with commercial insurance and government health plans
Experience using payer portals, clearinghouses and practice management systems
Strong written and spoken English, including phone calls with U.S. insurance companies
Excellent attention to detail and follow-up skills
Ability to work independently and manage multiple patient accounts
Reliable internet connection and a suitable remote workspace
Preferred Qualifications
Experience supporting a U.S. medical billing company or managing multiple practice accounts
Experience with surgical, orthopedic, gastroenterology, ASC or primary care billing and coding
Experience working through a remote desktop (RDP) environment
Experience with practice management systems such as AdvancedMD, eClinicalWorks, athenahealth or Kareo
Schedule
Full-time position
Must be available during U.S. business hours (Eastern Time)
Final schedule will be determined based on practice needs
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