job description
Join AdminEdge as a Remote Medical Billing & Coding Specialist and play a pivotal role in ensuring accurate and efficient processing of US healthcare claims, denials, and reimbursements. This fully remote position offers the flexibility to work from the vibrant locations of Bali, Indonesia, while contributing to a critical function in the US healthcare system.
As a specialist in this field, you will leverage your expertise in medical coding (ICD-10, CPT, HCPCS) and billing procedures to minimize claim rejections, optimize revenue cycles, and maintain compliance with US healthcare regulations. Your attention to detail and analytical skills will directly impact the financial health of healthcare providers and the satisfaction of patients.
AdminEdge is a trusted partner in healthcare administration, and we are seeking dedicated professionals who thrive in a dynamic, remote work environment. If you are passionate about precision, problem-solving, and making a difference in healthcare operations, this role is for you.
Responsibility
- Accurately review and process US medical claims using industry-standard coding systems (ICD-10, CPT, HCPCS).
- Identify and resolve claim denials by analyzing rejection reasons and implementing corrective actions.
- Ensure timely and accurate reimbursement processing for healthcare providers, adhering to payer guidelines.
- Collaborate with healthcare teams to clarify documentation and coding discrepancies.
- Maintain up-to-date knowledge of US healthcare regulations, including HIPAA, Medicare, and Medicaid policies.
- Generate and analyze reports to track billing performance, claim turnaround times, and denial rates.
- Communicate professionally with insurance companies, providers, and patients to resolve billing inquiries.
- Utilize medical billing software (e.g., Epic, Meditech, or similar) to manage claims efficiently.
Qualifications
- Certification in Medical Billing & Coding (e.g., CPC, CCS, or RHIT) is highly preferred.
- Minimum 2+ years of experience in US medical billing and coding, with a focus on claims processing and denials management.
- Proficiency in ICD-10, CPT, and HCPCS coding systems and familiarity with EHR/EMR platforms.
- Strong understanding of US healthcare payer systems (e.g., Medicare, Medicaid, commercial insurers).
- Excellent attention to detail and ability to work independently in a remote setting.
- Superior analytical and problem-solving skills to troubleshoot billing discrepancies.
- Fluent English communication skills (written and verbal) for collaboration with US-based teams.
- Reliable internet connection and a dedicated workspace to ensure productivity.