Billing Specialist - Remote (Healthcare Claims & Revenue Cycle Management)

Overview

Core-VA Solutions provides virtual administrative and billing support to healthcare providers across the United States. We are seeking a Billing Specialist with hands-on experience managing the full Revenue Cycle Management (RCM) process—from service documentation and claims submission to denial resolution and payment posting—while ensuring compliance with payer and state-specific requirements.

In Short

• Review and validate service documentation to ensure completeness and billing compliance.
• Verify insurance coverage and authorization requirements based on payer-specific and state regulations.
• Accurately code services using ICD, CPT, and HCPCS codes to reflect provided care.
• Submit claims through billing platforms or payer portals promptly and accurately.
• Monitor claim status and conduct follow-ups to ensure timely and full reimbursement.
• Post payments and reconcile transactions against billed amounts by service code, payer, and individual.
• Review and interpret EOBs, address denials, and prepare appeals or resubmissions as necessary.
• Ensure compliance with U.S. payer policies, industry standards, and applicable state billing requirements.
• Generate financial and billing reports to support internal audits, reconciliation, and revenue tracking.
• Collaborate with internal teams to resolve discrepancies in documentation or billing and maintain clean claims.

Requirements

• Hands-on experience with Revenue Cycle Management.
• Familiarity with U.S. healthcare clients.
• Strong knowledge of ICD and HCPCS coding.
• Ability to manage multiple tasks and deadlines.
• Excellent communication and collaboration skills.

Benefits

• Flexible remote working environment.
• Opportunity to work with healthcare professionals.
• Competitive salary based on experience.
• Comprehensive training and support.