Senior Medical Biller

Job Title

Experience

Shift Time

Company Website

Welcome to ModuleMD

At ModuleMD, we specialize in cloud-based EHR and Practice Management solutions for specialty healthcare providers. Were on a mission to revolutionize revenue cycle management through AI, and were looking for innovators who are ready to help us shape the future.

Our Culture & Values

"We foster a culture of inclusivity, innovation, and integrity. Our team values collaboration, continuous improvement, and a passion for excellence."

Profile Overview

We are seeking a Senior Medical Biller who is responsible for managing the complete medical billing cycle, ensuring accurate claim submissions, denial management, appeals, and compliance with payer regulations. The role requires hands-on experience with insurance portals like CHAMPS, Medicaid, and Medicare, and an in-depth understanding of billing workflows, A/R processes, and medical coding standards.

strong expertise in US Healthcare provider side, in AR Denial Management

Role Purpose:What You’ll Be Doing

• Perform end-to-end billing and collections for assigned accounts, ensuring claims are submitted accurately and in a timely manner.
• Work extensively on insurance websites such as CHAMPS, Medicaid, and Medicare to verify eligibility, check claim status, and process payments.
• Handle denials management, A/R follow-ups, rejections, and appeals efficiently to maximize reimbursement.
• Prepare and submit Medicare reconsiderations/appeals and understand related procedures such as ABN (Advance Beneficiary Notice), COB (Coordination of Benefits).
• Demonstrate strong working knowledge of what information should be included when filing an appeal for a denied claim.
• Apply accurate ICD-10 and CPT codes, ensuring compliance with payer and coding requirements.
• Review and interpret EOBs (Explanation of Benefits) and Payment Vouchers for payment posting and reconciliation.
• Maintain strict compliance with HIPAA regulations — including privacy, access, and release of information.
• Collaborate with internal teams to resolve complex billing issues and reduce denials.
• Keep updated with payer policy changes and medical billing guidelines.

• Maintain documentation

  on the client software to support insurance submissions and ensure a clear

  audit trail

  for future reference.

• Directly communicate with practices

  for billing clarifications, documentation, or dispute resolution.

• Post payments

  accurately as required.
• Conduct

  Denials Management and A/R follow-ups

  :
• Analyze accounts receivable data to identify reasons for underpayments and high A/R days.
• Track and document top denial reasons and apply appropriate codes in the billing system —

  MUST

  .
• Record

  after-call actions

  and complete

  post-call analysis

  for claim follow-ups —

  MUST

  .

• Comply

  with all terms of the employment contract, company policies, and procedures.

Must-Have Skills:

• Strong understanding of RCM end and 7+ years of experience in US Healthcare provider side AR and denial management.
• Excellent communication and reporting skills
• Strong analytical skills to interpret data, identify trends, and make informed decisions.
• Hands-on experience with TriZetto’s platforms or similar clearinghouse systems (e.g., Waystar, Availity) is highly preferred.
• Knowledge of healthcare compliance standards, including HIPAA and payer-specific regulations and other healthcare compliance standards.

Technical Knowledge:

• Strong skills in Denial management, Payment Posting, AR Follow-up, Appeals with strong Knowledge of the US healthcare industry and RCM.
• Proficiency in computer applications, PMS, Excel, and PPT.
• 7+ years of experience in US Healthcare provider side AR and Denial management.

Required Qualifications

• Education: Bachelor’s degree Healthcare Administration, or a related field.
• Minimum of 7 years of experience in revenue cycle management in US Healthcare provider side AR.
• Strong understanding of medical billing, coding, and collections processes.
• Proficiency in RCM software and Microsoft Office Suite.
• Excellent communication and interpersonal skills to interact with clients and payers.
• Proficiency in Microsoft Office (Excel, Word, Outlook).
• Detail-oriented with strong organizational and problem-solving skills.
• Ability to multitask in a fast-paced environment and meet deadlines.

Why Join ModuleMD?

• You’ll work at the intersection of AI and healthcare—real-world impact every day.
• Opportunity to work on cutting-edge healthcare technology and onboarding processes.
• Join a tight-knit, mission-driven team that values curiosity, autonomy, and innovation.
• Flexible work environment and a culture of continuous learning.

Application Process:

Equal Opportunity Statement

Ready to Join the Future of Healthcare AI?

Apply now with your GitHub/portfolio link and CV.