Senior Medical Billing Specialist – Primary Care

• Prepare, review, submit, and track medical claims for multiple U.S. primary care providers
• Apply ICD-10, CPT, HCPCS, and E/M billing concepts to identify billing errors and coding discrepancies
• Investigate rejected, denied, pending, downcoded, or unpaid claims and oversee corrections, resubmissions, appeals, and follow-ups
• Verify patient insurance eligibility, coverage, and benefits
• Oversee accounts receivable, outstanding balances, underpayments, denials, rejections, and payment discrepancies
• Review clinical documentation for billing accuracy, completeness, and compliance
• Coordinate with providers and internal staff to resolve documentation discrepancies
• Directly manage, supervise, and support a team of medical billing associates
• Assign and prioritize billing responsibilities and monitor team performance
• Provide coaching, guidance, and constructive feedback
• Develop and maintain standard operating procedures, training materials, and onboarding guides
• Prepare daily progress reports, billing updates, backlog summaries, and follow-up plans
• Communicate billing concerns, workflow challenges, and reimbursement risks to management
• Collaborate with providers, management, insurance representatives, and internal staff
• Improve billing workflows, accuracy, compliance, and revenue cycle performance

• At least 3 years of proven, hands-on U.S. medical billing experience (mandatory)
• Extensive experience in U.S. primary care medical billing (mandatory)
• Strong knowledge of primary care diagnoses, medical billing workflows, and reimbursement processes
• Advanced working knowledge of ICD-10, CPT, HCPCS, and E/M billing guidelines
• Experience preparing, reviewing, submitting, and tracking electronic medical claims
• Strong understanding of payer-specific billing requirements and timely filing deadlines
• Hands-on experience with accounts receivable, denials, rejections, downcoding, insurance appeals, and payer follow-ups
• Proven experience directly managing, supervising, or leading a team of medical billing associates (mandatory)
• Experience creating, maintaining, and updating departmental SOPs
• Ability to develop training materials, onboarding resources, and staff development processes
• Strong understanding of clinical documentation requirements for primary care billing
• Knowledge of billing-related compliance checks, risk mitigation, and escalation procedures
• Strong understanding of HIPAA and patient confidentiality requirements
• Proficiency with EHR/EMR systems, practice management software, and medical billing platforms
• Experience using electronic claims submission systems, clearinghouses, and insurance portals
• Strong proficiency with spreadsheets, claims trackers, billing reports, and productivity monitoring tools
• Excellent written and verbal English communication skills
• Must be able to submit an NBI Clearance and/or Local Police Clearance before onboarding (mandatory)
• Must be available for video meetings with camera on when required
• Must be available to work full-time, Monday through Friday, from 9:00 AM to 6:00 PM Eastern Time
• Reliable laptop or desktop computer
• Stable high-speed internet connection, minimum 25 Mbps
• Noise-canceling headset
• Working webcam
• Quiet and professional work environment

• Dedicated HR & Contractor Support Team
• Premium VPN Access (Optional)
• HIPAA & Cybersecurity Training + Certification (Provided)
• Top 1% VA Performance Training
• Client-Approved U.S. Holidays
• Client-Approved Paid or Unpaid Time Off (paid time off optional and only if offered by the client)
• Access to Tools & Resources
• Optional Performance-Based Incentives
• Optional bonuses, incentives, or increased hours based on performance