About Company
Join a dynamic team focused on optimizing healthcare financial processes! Career.zycto is rapidly expanding its remote operations, offering a supportive and innovative environment where your expertise in medical billing can truly make an impact. We pride ourselves on accuracy, efficiency, and fostering a collaborative culture, even across virtual teams. For a Medical Billing Specialist, this means a chance to streamline workflows, ensure compliant claims, and contribute directly to patient care by managing the financial backbone. We are committed to professional growth and providing the tools you need to excel from your home office.
Job Description
Career.zycto is seeking a highly skilled and detail-oriented Medical Billing Specialist to join our fully remote team. This is an exceptional opportunity for a motivated professional to leverage their expertise in a dynamic healthcare environment, ensuring the financial health of our operations from the comfort of their home office. As a Medical Billing Specialist, you will play a crucial role in our revenue cycle, responsible for the accurate and timely submission of medical claims, diligent follow-up on unpaid accounts, and meticulous denial management. Your contribution will directly impact our ability to provide essential services, making this a pivotal role within our organization.
We are looking for someone with a deep understanding of medical coding, insurance regulations, and the intricacies of the billing process. You will be instrumental in maintaining compliance with all HIPAA guidelines and healthcare laws, processing payments efficiently, and resolving patient inquiries with professionalism and empathy. The ideal candidate will be a self-starter, possess excellent problem-solving skills, and thrive in an independent yet collaborative virtual setting. If you are passionate about healthcare finance and excel at ensuring accuracy and efficiency in billing, we encourage you to apply. This role offers the flexibility of working remotely while being an integral part of a growing and supportive team dedicated to excellence in patient care support. You will be empowered to manage your workload effectively and contribute to a team-oriented culture that values precision and dedication.
Key Responsibilities
- Accurately prepare and submit medical claims to various insurance carriers (commercial, Medicare, Medicaid) using appropriate coding (CPT, ICD-10, HCPCS).
- Diligently follow up on unpaid and denied claims, investigating discrepancies, identifying root causes, and submitting appeals or corrected claims.
- Post patient payments, insurance remittances, and adjustments to patient accounts with precision and timeliness.
- Verify patient demographic, insurance eligibility, and benefits information prior to claim submission to minimize rejections.
- Respond to patient billing inquiries, explain statements, resolve payment disputes, and set up payment plans with a high degree of professionalism and empathy.
- Maintain strict confidentiality and adhere to all HIPAA regulations and compliance standards.
- Stay current with changes in billing regulations, coding guidelines, and insurance policies to ensure ongoing compliance.
- Collaborate effectively with clinical staff and other departments to obtain necessary documentation for claim processing and appeals.
- Generate and analyze aging reports, identify trends, and implement strategies to improve collection rates.
- Perform regular audits of patient accounts to ensure accuracy and resolve any billing discrepancies.
Required Skills
- Minimum of 2 years of recent experience in medical billing or revenue cycle management.
- Proficiency with medical billing software and electronic health record (EHR) systems (e.g., Epic, Cerner, AthenaHealth, Kareo).
- Strong understanding of CPT, ICD-10, and HCPCS coding guidelines and medical terminology.
- In-depth knowledge of various insurance plans and claim submission processes (PPO, HMO, Medicare, Medicaid).
- Exceptional attention to detail and a high level of accuracy in data entry and claim processing.
- Excellent written and verbal communication skills for patient interaction and insurance correspondence.
- Proven ability to work independently, prioritize tasks, and manage time effectively in a remote work environment.
- Strong problem-solving and analytical skills to resolve complex billing issues.
- High school diploma or equivalent.
Preferred Qualifications
- Associate's or Bachelor's degree in Healthcare Administration, Business, or a related field.
- Professional certification such as Certified Professional Biller (CPB), Certified Medical Reimbursement Specialist (CMRS), or Certified Professional Coder (CPC).
- Experience with Massachusetts state-specific billing regulations and payer requirements.
- Familiarity with telehealth billing procedures and regulations.
- Prior experience working in a fully remote or hybrid team setting.
Perks & Benefits
- Competitive salary commensurate with experience.
- Comprehensive health, dental, and vision insurance plans.
- Generous paid time off (PTO) and company-paid holidays.
- 401(k) retirement plan with company matching contributions.
- Flexible work-from-home schedule and environment.
- Opportunities for professional development and continuing education.
- Access to an Employee Assistance Program (EAP).
- Supportive and collaborative virtual team culture.
- Company-provided equipment for your home office setup.
How to Apply
To apply for this exciting Medical Billing Specialist opportunity, please submit your resume and a cover letter detailing your relevant experience and why you are an ideal fit for a remote role. We encourage you to highlight your expertise in medical coding, denial management, and your ability to work independently. Click on the application link below to proceed.
