Own day-to-day healthcare revenue cycle operations, from insurance verification and claims submission to payment posting, denial resolution, and patient collections, helping ensure timely reimbursement and clear billing for families.
Medical Billing Specialist (Claim Submission)
๐ Description
- Review claims for coding, demographic, and documentation issues before submission.
- Manage billing edits and claim-scrubbing workflows.
- Resolve coding issues, including CPT modifiers, diagnosis mismatches, and authorization discrepancies.
- Verify EHR demographics, insurance details, provider setup, and payer requirements.
- Monitor clearinghouse rejections, correct claims, and coordinate with internal teams and payers.
- Track recurring issues and support process improvements to reduce preventable denials.
๐ ๏ธ Requirements
- Bachelorโs degree or equivalent experience
- Excellent attention to detail and organizational skills
- At least 2โ3 years of experience in healthcare billing or revenue cycle operations
- Strong understanding of medical billing workflows, claim submission, and coding fundamentals
- Experience working with EHR systems, clearinghouses, and billing platforms
- Familiarity with commercial and government insurance requirements
- Strong communication and problem-solving abilities
- Comfortable working cross-functionally with clinical and operational teams
- Proficient in MS Office and business systems
- Ability to manage multiple priorities and meet deadlines in a fast-paced environment
Full job description
๐ About Alpaca Health
Alpaca Health enables clinicians to become entrepreneurs, starting in autism care.
We help clinicians launch and scale their own clinics by providing AI-powered software, payer contracting, and full back-office infrastructure. Our goal is simple: shift power in healthcare away from large consolidated entities and back to clinicians.
This role is remote. Weโre looking for candidates based outside of the United States, but able to work United States East Coast time zones.
๐ง What Youโll Do
We are looking for a detail-oriented Billing Specialist to own pre-submission billing accuracy and ensure clean claims are submitted correctly the first time. This role focuses on resolving coding issues, identifying EHR and demographic inaccuracies, and preventing downstream denials and rework. Specifically, this role will:
Review claims prior to submission to identify coding, demographic, and documentation issues
Own pre-submission billing edits and claim scrubbing workflows
Resolve coding-related issues including CPT modifiers, diagnosis mismatches, and authorization discrepancies
Review EHR data for demographic accuracy, insurance information, rendering provider setup, and payer requirements
Identify and correct missing or inaccurate patient, provider, or authorization data before claims submission
Coordinate with clinical, intake, credentialing, and operations teams to resolve billing blockers
Monitor clearinghouse rejections and ensure timely corrections and resubmissions
Maintain accurate billing records and claim documentation
Support process improvement initiatives to reduce preventable denials and increase clean claim rates
Assist with payer and clearinghouse communication via portal, fax, phone, and email
Track recurring claim issues and escalate systemic problems proactively
๐ง Who You Are
Bachelorโs degree or equivalent experience
Excellent attention to detail and organizational skills
At least 2โ3 years of experience in healthcare billing or revenue cycle operations
Strong understanding of medical billing workflows, claim submission, and coding fundamentals
Experience working with EHR systems, clearinghouses, and billing platforms
Familiarity with commercial and government insurance requirements
Strong communication and problem-solving abilities
Comfortable working cross-functionally with clinical and operational teams
Proficient in MS Office and business systems
Ability to manage multiple priorities and meet deadlines in a fast-paced environment
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