Employment Type: Independent Contractor | Full-Time & Part-Time
Work Arrangement: Fully Remote
Hours: 15–40 hours per week
Schedule: U.S. business hours based on client requirements and agreed availability
Time Zones: U.S. Eastern, Central, or Pacific Time
About the Role
We are seeking an experienced Bilingual Senior Medical Billing & RCM Specialist who is fluent in English and Spanish and has strong hands-on experience managing the U.S. healthcare billing and revenue cycle process.
This is a hands-on senior-level billing role for a professional who can independently manage billing workflows, claims, denials, accounts receivable, payment issues, and insurance follow-up within a U.S. healthcare environment.
The ideal candidate will have at least 3 years of direct U.S. healthcare medical billing experience, preferably within a medical practice, clinic, behavioral health organization, ophthalmology practice, dental practice, or other U.S. healthcare setting.
Candidates should be comfortable working across multiple stages of the revenue cycle and should have practical knowledge of medical billing, coding, claims management, denial resolution, AR follow-up, and payer processes.
What You'll Do
- Manage day-to-day U.S. medical billing and revenue cycle activities.
- Prepare, review, and submit accurate claims to Medicare, Medicaid, and commercial insurance payers.
- Review patient accounts, medical records, charges, and insurance information for billing accuracy.
- Apply and interpret CPT, ICD-10-CM, HCPCS, and applicable modifiers based on the practice's requirements.
- Identify and correct billing and coding errors before or after claim submission.
- Manage claim rejections, denials, corrections, appeals, and resubmissions.
- Perform Accounts Receivable (AR) follow-up on outstanding and aging claims.
- Investigate unpaid, underpaid, and incorrectly processed claims and follow up with insurance payers.
- Review EOBs and ERAs and reconcile payments against patient accounts.
- Perform or support payment posting and account reconciliation as required.
- Verify patient eligibility, insurance information, and benefits when required.
- Work with payer portals, clearinghouses, and billing systems to research and resolve claim issues.
- Monitor outstanding AR and take appropriate action to move accounts toward resolution.
- Identify recurring billing, coding, denial, or payment issues and communicate trends to the appropriate team.
- Communicate professionally with insurance companies, providers, patients, and internal teams.
- Maintain accurate billing documentation and follow client-specific processes and compliance requirements.
- Work independently in a remote environment while meeting accuracy, productivity, and turnaround-time expectations.
Required Qualifications
- Minimum 3 years of hands-on experience in U.S. medical billing, preferably in a medical practice, clinic, or healthcare organization.
- Direct experience supporting the U.S. healthcare revenue cycle.
- Hands-on experience with:
- Medical Billing
- Medical Coding
- CPT
- ICD-10-CM
- HCPCS
- Claims Submission
- Denial Management
- Accounts Receivable (AR)
- Insurance/Payer Follow-up
- Revenue Cycle Management (RCM)
- Experience working with U.S. insurance payers, including commercial insurance and/or Medicare/Medicaid.
- Working knowledge of EHR/EMR systems, clearinghouses, payer portals, or healthcare billing software.
- Fluent in English and Spanish, with the ability to communicate professionally in both languages.
- Strong attention to detail and ability to independently manage billing tasks and follow up on outstanding accounts.
- Comfortable working remotely and meeting client-specific productivity and quality expectations.
Preferred Qualifications
- Experience managing aging AR and complex denials.
- Experience with appeals and payer disputes.
- Experience with payment posting and EOB/ERA reconciliation.
- Experience with Medicare and Medicaid billing.
- Experience working with multiple insurance payers and payer portals.
- Experience within specialties such as:
- Primary Care
- Behavioral Health / Mental Health
- Ophthalmology
- Dental
- Specialty Clinics
- Other U.S. healthcare practices
- Medical billing or coding certification such as CPC, CCS, CPB, CCA, or equivalent.
Certification is preferred but not required. Strong hands-on U.S. billing experience is the priority.
What We Are Looking For
We are looking for experienced medical billing professionals who can work independently, not candidates whose experience is limited to general healthcare administration, scheduling, patient coordination, or basic data entry.
Strong candidates should be able to demonstrate experience with the full or significant portions of the U.S. revenue cycle, particularly:
Claims → Denials/Rejections → Payer Follow-up → AR → Payment/EOB/ERA Review → Account Resolution
Candidates with strong experience in denial management, AR follow-up, claims resolution, and payer communication are especially encouraged to apply.
Required Skills
- Medical Billing
- Medical Coding
- CPT
- ICD-10-CM
- HCPCS
- Revenue Cycle Management (RCM)
- Denial Management
- Accounts Receivable (AR)
- Claims Submission
- Insurance/Payer Follow-up
- EHR/EMR
Desirable Skills
- Payment Posting
- Medicare
- Medicaid
- Appeals
- Aging AR
- Billing Software
- Clearinghouses
- Payer Portals
- EOB/ERA
- Healthcare Billing
- Healthcare Practice Experience
