Medical Biller

Job Opening: Medical Billing Specialist

Location: South Africa (Remote – US Hours)
Type: Full-Time, Work from Home
Hours: Monday to Friday: 9am- 5pm (US Hours)

Job Summary:

We are seeking a detail-oriented and experienced Medical Billing Specialist with a strong background in ABA therapy billing. The successful candidate will manage the end-to-end billing process, ensuring accurate claim submissions, payment postings, and resolution of denied claims for ABA therapy services. Familiarity with insurance verification, CPT codes for ABA, and Medicaid/insurance guidelines is essential.

Key Responsibilities:

• Verify client insurance eligibility and benefits specific to ABA therapy.
• Accurately prepare and submit insurance claims (electronic and paper) for ABA services.
• Review and correct billing errors and ensure compliance with payer requirements.
• Post payments and reconcile insurance and patient accounts.
• Follow up on unpaid or denied claims; appeal and resolve denials in a timely manner.
• Communicate with insurance companies, clients, and internal teams regarding billing issues.
• Maintain patient confidentiality and adhere to HIPAA regulations.
• Generate patient statements and manage collections process as needed.
• Stay updated with billing codes and payer-specific rules.
• Assist in monthly reporting and analysis of billing performance and revenue cycle metrics.

Qualifications:

• Minimum 2 years of experience in medical billing, with a strong preference for ABA billing.
• Proficient in using billing software and electronic health records.
• Knowledge of ABA-specific CPT codes and insurance procedures.
• Strong understanding of payer guidelines including Medicaid, commercial insurance, and managed care.
• Excellent attention to detail, organizational, and time management skills.
• Effective communication and problem-solving abilities

Preferred Skills:

• Familiarity with insurance authorizations and re-authorizations.
• Experience in multi-state billing or handling multiple payers.
• Knowledge of HIPAA and other healthcare compliance standards
• Fluent or neutral English accent
• Reliable internet and backup power

Salary and Benefits

• Comfortable working U.S. hours
• Remote work