Medical Biller & Revenue Cycle Specialist

Remote | Behavioral Health | 30 hours/week | 11:00 AM to 7:00 PM US Central

$6.5-$7.5/hour + 6th month performance review

Role Overview

We are seeking an experienced Medical Biller & Revenue Cycle Specialist to support a nonprofit behavioral health organization in the United States. This is an experienced-level position for someone who can independently oversee and strengthen the clinic's medical billing and revenue cycle processes.

The clinic's clinicians document their visits in AdvancedMD and enter the applicable billing codes and initial charge information. The Medical Biller will review that information, ensure billing activity is accurate and timely, process and track claims, manage denials and outstanding Accounts Receivable, support payment reconciliation, monitor revenue-cycle performance, and help establish reliable billing procedures.

The organization is looking for more than someone who can simply process assigned claims. The successful candidate will serve as a billing subject-matter resource, identify problems the clinic may not yet recognize, recommend solutions, and help develop effective Standard Operating Procedures.

Key Responsibilities

• Billing & Charge Review: Review clinician-entered documentation, billing codes, charge information, and charge slips for completeness and accuracy before claims are processed.
• Coding Validation: Review applicable ICD-10, CPT, HCPCS, and modifier information for consistency with documented services.
• Claim Creation & Submission: Compile and validate patient, provider, payer, diagnosis, procedure, and service information required for claim submission.
• Claim Adjudication: Monitor submitted claims throughout the payer adjudication process for approval, rejection, denial, underpayment, or other outcomes.
• Denial Management & Appeals: Research denied or rejected claims to determine root cause and identify the appropriate corrective action.
• Accounts Receivable Follow-Up: Review and prioritize outstanding Accounts Receivable based on aging, payer, claim status, value, and urgency.
• Payment Posting & Reconciliation: Post insurance payments, contractual adjustments, deductibles, copays, coinsurance, and other applicable amounts accurately.
• Patient Billing: Review remaining patient responsibility after insurance adjudication and confirm that patient balances are accurate.
• Provider Credentialing: Assist with new provider payer enrollment, credentialing applications, attestations, and required supporting documentation.
• Billing Reporting & KPI Monitoring: Monitor key revenue-cycle indicators including denial rates, Days in Accounts Receivable, AR aging, outstanding claims, and collection performance.
• Auditing & Compliance: Conduct internal reviews of billing activity to identify errors, documentation problems, compliance concerns, and workflow gaps.
• Process Improvement: Analyze recurring billing, coding, documentation, AR, and payer issues to identify their underlying causes.
• SOP Development: Document workflows for charge review, claim submission, denials, AR follow-up, appeals, and payment posting.

Required Qualifications

• Minimum 2 years of medical billing, revenue cycle management, coding, or closely related US healthcare billing experience.
• Strong understanding of the end-to-end US medical billing lifecycle.
• Strong working knowledge of ICD-10, CPT, and HCPCS coding systems.
• Experience with claim creation and submission.
• Experience managing denied and rejected claims.
• Experience with Accounts Receivable follow-up.
• Experience communicating directly with US insurance companies.
• Understanding of EOBs, ERAs, payment posting, and patient responsibility.
• Experience using medical billing software and EHR systems.
• Ability to independently research and resolve claim issues.
• Strong analytical, organizational, and problem-solving skills.
• Exceptional attention to detail and accuracy.
• Professional written and verbal communication skills.
• Strong HIPAA and healthcare compliance awareness.
• Ability to work independently with limited supervision.
• Reliable and punctual attendance.

Preferred Qualifications

• Previous experience using AdvancedMD.
• Behavioral health or mental health billing experience.
• Medicaid billing experience.
• Provider credentialing and payer enrollment experience.
• Experience creating medical billing SOPs.
• Experience performing revenue-cycle audits.
• Experience analyzing billing KPIs and AR performance.
• Demonstrated experience reducing denials, resolving aged AR, or improving billing workflows.

Systems & Tools

The primary billing and EHR platform is: AdvancedMD. The position may also use: Insurance payer portals, Clearinghouse systems, Microsoft Teams, Phone services, Reporting and spreadsheet tools, VPN and secure remote-access systems, Time Doctor.

Remote Work Requirements

Candidates must maintain: Dedicated private workspace suitable for confidential healthcare and financial information, Reliable computer capable of supporting AdvancedMD and other billing applications, Stable primary internet connection, Reliable backup internet, Verified backup power source, Secure and professional remote working environment, Strong information-security and HIPAA practices.