Job Overview

 Are you an experienced medical billing professional with a strong background in healthcare revenue cycle management and commercial insurance claim processing? Our client is seeking a detail-oriented, self-driven individual who understands insurance policies, authorization procedures, medical terminology, and payer guidelines, including appeals processes like Cigna. Familiarity with EHR and medical accounting platforms is essential, with AdvancedMD experience highly preferred. If you thrive in a remote environment, stay organized under pressure, and can accurately manage paperwork while minimizing errors, this is your opportunity to grow with a dynamic and expanding practice where your expertise and initiative will make a direct impact every day. 

Schedule

• Monday – Friday, 8:00 AM – 4:30 PM Eastern Standard Time (EST), with a 30-minute unpaid lunch break (40 hours per week).

Responsibilities

Claims Management & AdvancedMD Processing

• Claim Submission: Prepare, scrub, and submit clean medical insurance claims through the AdvancedMD Electronic Health Record (EHR) and billing platform.
• Charge Entry & Posting: Manage high-accuracy charge submissions, code verification, and patient/insurance payment posting entries.
• Accounts Receivable Follow-Up: Monitor claim adjudication pipelines, track aging accounts receivable, and proactively execute follow-ups on delayed or stuck claims.

Denial Management & Appeals Operations

• Complex Appeals: Construct, document, and submit sophisticated appeal packages to overturn insurance denials, with a heavy focus on navigating challenging commercial payers such as Cigna.
• Error Correction: Analyze explanation of benefits (EOBs) and remittance advices to diagnose rejection root causes and implement corrective re-submissions promptly.

Program Scaling & Collaboration

• Process Optimization: Partner closely with internal clinical and administrative teams to optimize documentation workflows and clear billing bottlenecks.
• Expansion Support: Contribute tactical insights to support the strategic expansion and structural improvement of the organization's broader insurance program.
• Inquiry Resolution: Respond promptly and professionally to internal and external insurance-related inquiries regarding coverage, billing policies, and structural compliance.

Requirements

• Industry Experience: Proven, hands-on experience in medical billing, healthcare revenue cycle management, or commercial insurance claim processing.
• Tech Stack Fluency: Practical familiarity with modern Electronic Health Record (EHR) and medical accounting systems. Direct knowledge or prior utilization of AdvancedMD is highly preferred.
• Payer Navigation IQ: Solid understanding of major insurance policies, authorization procedures, medical terminology, and specific payer guidelines (such as Cigna appeals processes).
• Meticulous Precision: Exceptional organizational habits, paperwork management skills, and a high level of attention to detail to minimize coding and entry errors.
• Autonomy & Agility: A self-starter who thrives independently in a virtual environment and possesses the adaptability to handle an increasing workload as the practice expands.

Independent Contractor Perks

• Permanent work from home
• Immediate hiring
• Health Insurance Coverage for eligible locations 

Note

Please click the "Apply" button to complete your application, including the assessment questions, technical check, and voice recording. Your hourly pay rate will be established based on your performance in the application process; submissions with all requirements fulfilled will receive priority review.