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    • Strong understanding of medical billing workflows, claim submission, and coding fundamentals.
    • Maintain accurate billing records and claim documentation.
    • Submit medical claims accurately and efficiently to insurance payers.
    • You will spend the majority of your day submitting medical claims, following up with…
    • Identify and correct medical billing errors impacting claim payment.
    • Ensure timely resolution of unpaid, denied, or partially paid claims.
    • Identify and correct medical billing and coding-related errors impacting claim payment.
    • Medical billing and claims processing.
    • At least a High School Graduate.
    • 2+ years of experience working closely with US healthcare claims or in a claims processing/adjudication environment.
    • Work Setup: In‑Office Training Required.
    • Identify and correct medical billing errors.
    • Track and report claim trends to minimize denials.
    • Analyze and resolve claim discrepancies to prevent payment…
    • Experience with claims management software and electronic claim submission platforms.
    • At least 1 year of experience in *healthcare claims processing or claims…
    • Strong experience calling insurance payers to verify claims and resolve disputes.
    • Resolve denied, delayed, unpaid, or underpaid claims.
    • Experience handling medical billing claims / insurance claims follow-up.
    • Follow up on unpaid, delayed, or denied medical claims.
    • Track claim submissions, resolving pre-bill edits and rejections promptly.
    • Issue adjusted, corrected, or rebilled claims to insurance companies.
    • Knowledge of compliance and audit requirements related to hospice care claims.
    • Minimum of 2 years experience in insurance denials management with a focus on…
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    • Familiarity with medical necessity criteria, payer policies, and reimbursement methodologies.
    • Review medical records, payer policies, and coding guidelines to…
    • Strong grasp of medical terminology and human anatomy.
    • Remain informed with medical coding and billing regulatory changes to contribute continuous improvement…
    • Encode charts accurately to process insurance claims.
    • Submit claim forms to insurers for reimbursement.
    • Review and analyze patients’ medical records after…
  • View similar jobs with this employer
    • Familiarity with medical necessity criteria, payer policies, and reimbursement methodologies.
    • Review medical records, payer policies, and coding guidelines to…

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Job Post Details

Medical Billing Specialist (Claim Submission) - job post

Alpaca Health
Philippines•Remote

Job details

Job type

  • Full-time

Full job description

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. We’re looking for candidates based outside of the United States, but able to work United States East Coast time zones.

What You’ll 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

Who You Are

  • Bachelor’s degree or equivalent experience

  • Excellent attention to detail and organizational skills

  • 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

  • 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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