Job Description

Job Description

Job Description

Company Description 

ModuleMD is a leading provider of innovative healthcare solutions, specializing in Electronic Health Records (EHR) and AI-driven tools designed to enhance clinical workflows. ModuleMD is dedicated to streamlining medical processes and improving patient care through cutting-edge technology. Our solutions are trusted by healthcare professionals seeking efficiency and accuracy. Join our dynamic team to contribute to advancing healthcare technology. 

Role Description 

This is a full-time remote role for a Medical Billing Specialist. The Medical Billing Specialist will be responsible for managing billing processes, handling insurance claims, processing denials, and ensuring accurate application of medical coding (ICD-10). This role also involves working with Medicare and other insurance providers to maximize revenue and ensure compliance. 

Responsibilities 

• Review, prepare, and submit accurate medical claims (electronic and paper) to insurance carriers. Ensure claims are clean to avoid rejections. 
• Interact effectively and professionally with medical offices and their patients on behalf of ModuleMD providing information about their insurance payments and claims processing.
• Perform charge entry using CPT, ICD-10, and HCPCS codes. 
• Provide medical offices with education on best practices in billing to improve overall success. 
• Maintain strict compliance with HIPAA and all applicable federal/state regulations. 
• Keep up to date with billing rules, insurance requirements, and payer policy changes. 
• Review rejections and file corrected claims. 
• Research and appeal denied claims. 
• Access carrier websites for claim and eligibility information 
• Interpret and process Explanation of Benefits. 
• Monitor client accounts and provide weekly updates identifying issues and possible resolutions.
• Post payments 
• Bill patients for responsible portions and have the ability to relay information regarding copays, deductibles and coinsurance. 
• Answer patient calls regarding statements and balances.

Required Qualification 

• Associate’s degree or higher 
• Minimum of 3 years’ experience in medical billing, coding or healthcare revenue cycle operations. 
• Strong understanding of medical terminology, coding systems (CPT, ICD-10), and billing guidelines.
• Understanding of modifier usage (e.g., 25, 59, 51, 50) in dermatology billing.
• Proficiency in medical billing software and EHR systems 
• Familiar with Dermatology-specific LCD/NCD policies. 

Preferred Experience

• 2–3 years’ experience in Dermatology billing or similar specialty.
• CPC or CPB certification (AAPC) preferred.
• Experience differentiating cosmetic vs. medically necessary procedures and billing accordingly.

Skills Required 

• Effective communication skills 
• Basic to advance computer skills: MS Office Suite - Word, Excel 
• Creative problem-solving skills 
• Work Independently as well as be a collaborative team member 
• Multitasking 

Benefits 

Health Insurance, vision, dental coverage 

Paid vacation policy 

Remote work – flexible schedule 

Why Join ModuleMD? 

• Make a direct impact on healthcare delivery by shaping the financial success of practices.

• Work in a mission-driven, innovation-focused company with growth opportunities.

• Collaborate with a talented, diverse team and cutting-edge technology. 

• Competitive salary, benefits, and professional development opportunities.

ModuleMD is a leading AI-powered EHR and Practice Management software provider offering integrated Revenue Cycle Management services, with a strong focus on Allergy, Immunology, and Respiratory Health. We are on a mission to empower practices to reach new heights and deliver outstanding healthcare experiences through cutting-edge technology and insightful, knowledge-based service.

Company Description

ModuleMD is a leading AI-powered EHR and Practice Management software provider offering integrated Revenue Cycle Management services, with a strong focus on Allergy, Immunology, and Respiratory Health. We are on a mission to empower practices to reach new heights and deliver outstanding healthcare experiences through cutting-edge technology and insightful, knowledge-based service.

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