Physician Billing Specialist

Job Summary

To support healthcare providers, the full-time remote Physician Billing Specialist will manage the full lifecycle of claims, including eligibility verification, claim submission, and accounts receivable follow-up while working directly within client EHR and billing systems.

Key responsibilities:

• Verify insurance coverage and benefits, document details, and determine payer order based on coordination of benefits rules
• Submit clean claims directly to payers and resolve front-end claim edits and rejections at the source system level
• Analyze denial trends, collaborate with cross-functional teams, and document account activity while maintaining compliance with regulations

Required qualifications:

• High School Diploma or GED; CRCR or CRCS certification preferred
• 3-5 years of experience in hospital and/or physician revenue cycle, covering areas such as billing, AR follow-up, and denial management
• Hands-on experience submitting claims directly to payers via Medicare DDE/FISS and state Medicaid portals
• Comprehensive knowledge of UB-04 and CMS-1500 claim forms, revenue codes, and major payer processes
• Strong analytical skills and proficiency in Excel for data management and reporting