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Medical Billing & Revenue Cycle Specialist

Wholesum Billing

Responsible for managing the full cycle of healthcare billing and revenue cycle activities, including claims processing, accounts receivable follow-up, payment posting, coding, reconciliation, denial management, and reimbursement.

The role supports operational excellence through accurate billing, efficient reimbursement, and strong payer communication. Work is scheduled Monday through Friday, 8:00 AM to 5:00 PM Central Time, with occasional weekends as needed. Candidates must reside in the U.S.

Key duties include:

  • Review and submit insurance claims accurately and on time.
  • Verify patient demographics, insurance eligibility, authorizations, and billing information.
  • Post patient and insurance payments, including EFTs and electronic remittances.
  • Review and process EOBs and ERAs to ensure accurate payment application.
  • Research and resolve denied, unpaid, or underpaid claims.
  • Follow up with insurance carriers regarding outstanding accounts receivable balances.
  • Navigate payer portals to verify claim status and obtain remittance details.
  • Maintain detailed account documentation and reconciliation records.
  • Collaborate with billing, coding, analyst, and payment posting teams to improve efficiency.
  • Identify reimbursement trends and recommend process improvements.
  • Maintain HIPAA, PHI, and CMS compliance standards.
  • Provide professional communication and customer service to patients, providers, insurance carriers, and internal departments.
Requirements & Qualifications
  • 3–5 years of experience in healthcare billing, accounts receivable, payment posting, or revenue cycle operations preferred.
  • Experience with Medicare, Medicaid, managed care, and commercial insurance billing.
  • Strong understanding of EOBs, ERAs, CPT, ICD-10, HCPCS, modifiers, and denial management.
  • Experience using insurance portals and EDI tools such as Availity, Optum, Payspan, or similar systems.
  • Strong analytical, organizational, and problem-solving skills.
  • Ability to multitask and work effectively in a fast-paced healthcare environment.
  • Proficiency in Microsoft Office, especially Excel and Outlook.
  • Strong written and verbal communication skills.
  • High school diploma or equivalent required.
Benefits & Perks
  • Medical insurance
  • Vision insurance
  • Dental insurance
  • 401(k)
  • Pension plan
  • Paid maternity leave
  • Disability insurance

Location

N/A

Employment Type

Full-time

Experience Level

Associate

Remote work allowed

Yes

Posted

1 week ago

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