Medical Billing Specialist (US Clinic)

About the Role A U.S.-based clinic is looking for an experienced Medical Billing Specialist to manage claims, insurance follow-up, and revenue cycle tasks. This role requires direct experience with U.S. insurance billing — not general bookkeeping or admin experience.

Responsibilities

• Prepare and submit claims to insurance payers (Medicare, Medicaid, and commercial insurance)
• Verify patient insurance eligibility and benefits prior to visits
• Apply correct CPT, ICD-10, and HCPCS codes, or work closely with coders to ensure accuracy
• Track claim status and follow up on unpaid, denied, or underpaid claims
• Submit appeals for denied claims with appropriate documentation
• Post payments and reconcile insurance remittances (EOBs/ERAs)
• Manage patient billing inquiries and outstanding balances
• Maintain accurate records in the clinic's billing/EHR system
• Stay current on payer policy changes and billing regulation updates
• Identify and correct billing errors before claims are submitted to reduce denials

Requirements

• Proven experience in U.S. medical billing, ideally within a clinic or physician practice setting
• Strong understanding of insurance claim processes, including Medicare/Medicaid and commercial payers
• Familiarity with CPT, ICD-10, and HCPCS coding
• Experience with claim denials, appeals, and payer follow-up
• Comfortable using EHR/billing software (e.g., Kareo, AdvancedMD, athenahealth, or similar)
• Understanding of HIPAA compliance and patient data confidentiality
• Strong attention to detail and accuracy with financial and medical data
• Clear written and verbal English communication

Nice to Have

• Medical billing certification (CPB, CPC, or similar)
• Experience with a specific specialty (e.g., family medicine, dermatology, behavioral health)
• Experience working directly with U.S. clinics as a remote/offshore team member