Medical Billing Specialist – Claim Submission

🔥 59 minutes ago

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Alpaca Health

WebsiteLinkedInAll Job Openings

2 - 10 employees

Founded 2024

🏥 Healthcare

👥 B2C

Healthcare • B2C

Alpaca Health is a provider network that delivers personalized Applied Behavior Analysis (ABA) therapy for children with autism spectrum disorder and developmental delays. They connect families with local, independent clinicians (BCBAs and therapists) and offer flexible care models — in-home, in-clinic, in-school, in-daycare, in-community, and virtual sessions — designed to integrate into a family’s daily routine. Alpaca Health provides diagnostic support (including free online screening tools and ADOS-2 assessments for young children), accepts many major insurance plans and is in-network with 100+ payers across states such as Texas, Colorado, North Carolina, and Hawaii.

📋 Description

• Own pre-submission billing accuracy and ensure clean claims are submitted correctly • 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 • Assist with payer and clearinghouse communication via portal, fax, phone, and email • Track recurring claim issues and escalate systemic problems proactively

🎯 Requirements

• Bachelor’s degree or equivalent experience • At least 2–3 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 • Proficient in MS Office and business systems. • Ability to manage multiple priorities and meet deadlines in a fast-paced environment

🏖️ Benefits

• This role is remote. • Working outside of the United States, but able to work United States East Coast time zones. • Support process improvement initiatives to reduce preventable denials and increase clean claim rates.