Company Description

ModuleMD is a leading provider of innovative healthcare solutions, specializing in Electronic Health Records (EHR) and AI-driven tools designed to enhance clinical workflows. ModuleMD is dedicated to streamlining medical processes and improving patient care through cutting-edge technology. Our solutions are trusted by healthcare professionals seeking efficiency and accuracy. Join our dynamic team to contribute to advancing healthcare technology.

Role Description

This is a full-time remote role for a Medical Billing Specialist. The Medical Billing Specialist will be responsible for managing billing processes, handling insurance claims, processing denials, and ensuring accurate application of medical coding (ICD-10). This role also involves working with Medicare and other insurance providers to maximize revenue and ensure compliance.

Responsibilities

• Review, prepare, and submit accurate medical claims (electronic and paper) to insurance carriers. Ensure claims are clean to avoid rejections.
• Interact effectively and professionally with medical offices and their patients on behalf of ModuleMD providing information about their insurance payments and claims processing.
• Perform charge entry using CPT, ICD-10, and HCPCS codes.
• Provide medical offices with education on best practices in billing to improve overall success.
• Maintain strict compliance with HIPAA and all applicable federal/state regulations.
• Keep up to date with billing rules, insurance requirements, and payer policy changes.
• Review rejections and file corrected claims.
• Research and appeal denied claims.
• Access carrier websites for claim and eligibility information
• Interpret and process Explanation of Benefits.
• Monitor client accounts and provide weekly updates identifying issues and possible resolutions.
• Post payments
• Bill patients for responsible portions and have the ability to relay information regarding copays, deductibles and coinsurance.
• Answer patient calls regarding statements and balances.

Required Qualification

• Associate’s degree or higher
• Minimum of 3 years’ experience in medical billing, coding or healthcare revenue cycle operations.
• Strong understanding of medical terminology, coding systems (CPT, ICD-10), and billing guidelines
• Proficiency in medical billing software and EHR systems
• Experience in Allergy & Immunology billing is preferred

Skills Required

• Effective communication skills
• Basic to advance computer skills: MS Office Suite – Word, Excel
• Creative problem-solving skills
• Work Independently as well as be a collaborative team member
• Multitasking

Benefits

• Health Insurance, vision, dental coverage
• Paid vacation policy
• Remote work – flexible schedule

Why Join ModuleMD?

• Make a direct impact on healthcare delivery by shaping the financial success of practices.
• Work in a mission-driven, innovation-focused company with growth opportunities.
• Collaborate with a talented, diverse team and cutting-edge technology.
• Competitive salary, benefits, and professional development opportunities.

To Apply: Send your resume and a brief cover letter outlining your experience and interest in the role to [careers.us@modulemd.com]