medical billing and coding specialist

Qualix Solutions

Employment Type: Full-Time, Project-Based ContractDuration: 3 months (with potential for renewal or full-time position)Location: Onsite (PECHS, Karachi)About the RoleQualix Solutions is working on an innovative health tech product for a client building an AI-powered medical documentation and billing platform focused on cardiovascular and vascular procedures. The platform leverages advanced AI to improve documentation accuracy, streamline coding workflows, and optimize insurance reimbursement for hospitals and surgical teams.We are seeking a Medical Coding Specialist to help us accurately code procedures using CPT, HCPCS, ICD-10, and ICD-9 (via crosswalk mapping) codes. This is an opportunity to help shape an AI product from the ground up. You will work directly with our medical, development, and AI engineering teams to build coding logic that drives better documentation and billing outcomes.Our initial focus is on catheterization lab and vascular procedures, but we plan to expand into additional surgical specialties, so strong foundational knowledge of anatomy is essential.Work Environment Requirements<ul><li>Onsite onboarding with our medical and development teams is required before transitioning to remote work.</li><li>Working hours must align with US Eastern or Pacific time zones for team calls and collaboration.</li><li>Reliable internet connection for web conferencing.</li><li>Must appear on camera during video calls.</li><li>A quiet workspace with good lighting and audio quality is essential.</li></ul>ResponsibilitiesMedical Data Review and Annotation<ul><li>Review catheterization lab recordings to capture procedure details, anatomical locations, supplies used, and clinical findings.</li><li>Analyze vascular and echocardiogram ultrasound recordings and reports to identify relevant anatomy and contribute to platform training.</li><li>Correlate supply, anatomy, and clinical details with insurance reimbursement reports for cardiovascular procedures.</li><li>Assign appropriate CPT, HCPCS, ICD-10, and ICD-9 (crosswalked) codes to procedures and findings.</li><li>Research and document codes to address platform issues and minimize insurance delays or denials.</li></ul>Data Enrichment<ul><li>Create decision frameworks that help medical staff and our AI (Large Language Model) select the most precise codes for a given procedure or finding.</li><li>Support updates for the 2026 coding rules refresh.</li></ul>Quality Assurance<ul><li>Identify and resolve inconsistencies or errors in existing coding logic.</li><li>Guide corrections to AI-generated coding suggestions.</li><li>Uphold high standards for accuracy and completeness across all coding processes.</li></ul>Collaboration<ul><li>Provide constructive feedback to developers and AI engineers on coding accuracy.</li><li>Participate in workflow improvement discussions.</li><li>Help refine coding guidelines as the product evolves.</li></ul>Administrative AI Workflow<ul><li>Learn and implement AI tools to streamline daily operations and data entry.</li><li>Engage with various AI platforms that support operations, admin, and marketing functions.</li></ul>RequirementsEducation and Background<ul><li>Medical student, physician (recent graduates welcome), sonographer, medical coder, or other relevant medical field experience.</li><li>Strong foundational knowledge of human anatomy and medical terminology.</li><li>Familiarity with catheterization labs, vascular/hybrid surgery labs, vascular ultrasounds, or echocardiograms is a strong plus.</li><li>Familiarity with operating rooms and surgical procedures is a plus.</li></ul>Skills<ul><li>Understanding of US healthcare insurance billing rules and payer requirements.</li><li>Exceptional attention to detail and ability to follow structured guidelines.</li><li>Basic computer proficiency, including comfort with Excel and web-based tools (training on our platform will be provided).</li><li>Openness to learning new web technologies that can contribute to platform growth.</li><li>Interest and willingness to engage with AI platforms that support operations and workflows.</li></ul>Certifications (Preferred)<ul><li>CPC, CCS, or equivalent medical coding certification.</li></ul>Availability<ul><li>Full-time commitment for a minimum of 3 months.</li><li>Flexibility to align with US Eastern or Pacific time zones for team meetings.</li><li>Good internet access is required for Work-from-home; video sharing and being on camera during conference calls is mandatory.</li></ul>Job Type: Full-timeApplication Question(s):<ul><li>What is your current salary?</li><li>What is your expected salary?</li><li>Is your expected salary negotiable?</li><li>Please rate your English communication skills on a scale of 1 (Novice) to 10 (Expert)?</li></ul>Work Location: In person

Medical Coding Specialist (US Healthcare)

CrecenTech

Overview: CrecenTech Systems Private Limited is seeking a results-driven Senior Business Development Specialist &ndash; Medical Billing to accelerate business growth within the international healthcare and Revenue Cycle Management (RCM) services market. This role is ideal for a professional who excels at developing new business opportunities and building long-term partnerships with healthcare organizations.Key Responsibilities:<ul><li>Identify and pursue new business opportunities for Medical Billing and RCM services</li><li>Conduct outbound prospecting through calls, emails, and professional networking platforms</li><li>Engage with healthcare providers to understand their billing and revenue cycle needs</li><li>Present and promote service offerings, including Medical Billing, Coding, Accounts Receivable, and Denial Management</li><li>Assist in proposal development, pricing negotiations, and contract closures</li><li>Maintain accurate sales pipelines, forecasts, and activity records using CRM tools</li><li>Collaborate with internal teams to ensure smooth client onboarding and seamless service delivery</li><li>Achieve assigned monthly and quarterly business development targets</li><li>Stay informed about healthcare industry trends, billing practices, and compliance standards</li></ul>Required Qualifications:<ul><li>Bachelor&rsquo;s degree in Business, Marketing, Healthcare Management, or a related field</li><li>Minimum of 3 years of experience in business development or sales (experience in medical billing services is a plus)</li><li>Solid understanding of medical billing and revenue cycle workflows</li><li>Excellent communication, negotiation, and relationship-building skills</li><li>Hands-on experience with CRM or sales management tools</li><li>Ability to work with international clients and flexible working hours</li></ul>Preferred Qualifications:<ul><li>Experience selling Medical Billing, Coding, or RCM-related services</li><li>Familiarity with professional networking and lead generation platforms</li><li>Prior exposure to healthcare or medical service environments</li></ul>Benefits:<ul><li>At least two bonuses per year (Eid Bonus)</li><li>Commission Offered</li><li>Performance-Based Bonuses</li><li>Maternity/Paternity Allowance</li><li>Maternity Leaves</li><li>Wedding Allowance</li><li>Annual Leaves Encashment</li><li>Double salary on Gazetted Holidays</li><li>Special Allowance for Emergency</li><li>12 Casual Leaves</li><li>10 Medical Leaves</li><li>10 Annual Leaves</li><li>Dedicated Training</li><li>Birthday celebrations</li><li>Gaming Facility</li><li>Growing &amp; Dynamic Team</li><li>Office Gatherings, Celebrations, and Trips</li><li>5 days a week (work-life balance)</li></ul>Job Location: Link Road Model Town, Lahore Job Timings: 6 PM to 3 AM (5 days a week)Job Type: Full-timeApplication Question(s):<ul><li>How many years of experience do you have in business development or sales?</li><li>Are you comfortable conducting outbound prospecting through calls, emails, and professional networking platforms?</li><li>Are you comfortable working in night Shift?</li><li>What are your expected salary?</li></ul>Experience:<ul><li>Medical Billing: 3 years (Required)</li></ul>Language:<ul><li>English (Required)</li></ul>Location:<ul><li>Lahore Model Town (Required)</li></ul>Work Location: In person

Business Development Specialist – Medical Billing

M E society

*Hiring alert* *Job Title: Medical Coding and Billing Instructor* *Job Type: Full-time/Part-time* *Location: Hyderabad *Job Description:* We are seeking an experienced Medical Coding and Billing professional to join our team as an Instructor. The ideal candidate will have a strong background in medical coding and billing, excellent communication skills, and a passion for teaching. *Responsibilities:* - Develop and deliver engaging training programs for medical coding and billing students - Create and update curriculum and course materials - Assess student progress and provide feedback - Stay current with industry trends and updates in medical coding and billing *Requirements:* - Certified Medical Coder (CIC, CPC, CCS, or equivalent) - 2+ years of experience in medical coding and billing - Excellent communication and teaching skills - Bachelor's degree in a related field (Master's degree preferred) *What we offer:* - Competitive salary - Opportunities for professional growth - A dynamic and supportive work environment *How to apply:* Send your resume and a cover letter to 8019919866Job Types: Full-time, Part-time, Permanent, FresherPay: ₹20,000.00 - ₹40,000.00 per monthBenefits:<ul><li>Cell phone reimbursement</li><li>Flexible schedule</li><li>Internet reimbursement</li><li>Leave encashment</li><li>Paid time off</li><li>Work from home</li></ul>Work Location: In person

Medical Coder; billing instructor

Bbm solutions

Responsibilities:<ul><li>Submit and follow up on medical claims to ensure timely payment.</li><li>Resolve billing discrepancies and insurance denials.</li><li>Manage accounts receivable and monitor AR aging.</li><li>Maintain accurate billing records and generate reports.</li></ul>Requirements:<ul><li>Proven experience in medical billing and AR.</li><li>Knowledge of medical coding, insurance, and billing software.</li><li>Detail-oriented with strong communication skills.</li></ul>Job Type: Full-timePay: Rs70,000.00 - Rs100,000.00 per monthWork Location: In person

Senior Medical Billing Executive/ AR Specialist

Virtelligence

Digital Marketing Specialist &ndash; Medical Billing &amp; (RCM)About VirtelligenceVirtelligence is a leading global IT and healthcare technology consulting firm with over 25 years of experience, supporting more than 200 health systems and enterprise clients worldwide.We specialize in digital transformation, cloud adoption, healthcare technology solutions, and innovative workforce services.Website: https://www.virtelligence.com LinkedIn: https://www.linkedin.com/company/virtelligence/Job DetailsCompany: Virtelligence Location: I-10/3, Islamabad (On-site) Shift: Night Shift Experience Required: 3+ Years in Digital Marketing (Healthcare / Medical Billing Preferred)Role OverviewVirtelligence is seeking a strategic and performance-driven Digital Marketing Specialist with a strong understanding of Medical Billing and Revenue Cycle Management (RCM).The ideal candidate will possess hands-on experience in B2B marketing within the US healthcare market and a clear understanding of ICD-10, CPT coding, payer reimbursement structures, and end-to-end RCM workflows.This role requires the ability to position complex medical billing services into compelling digital campaigns that attract private practices, physician groups, and healthcare systems.Key ResponsibilitiesDigital Strategy &amp; Campaign Management<ul><li>Develop and execute digital marketing strategies focused on promoting medical billing and RCM services.</li><li>Plan and manage multi-channel campaigns including LinkedIn, Google Ads, email marketing, and SEO.</li><li>Optimize campaigns for lead generation and conversion performance.</li></ul>Healthcare Market Positioning<ul><li>Create targeted messaging tailored to US-based healthcare providers.</li><li>Develop content strategies focused on improving Days in A/R, Net Collection Rates, and Clean Claim Ratios.</li><li>Position Virtelligence as a trusted RCM and healthcare technology partner.</li></ul>Lead Generation &amp; Funnel Optimization<ul><li>Generate qualified B2B leads through inbound and outbound digital strategies.</li><li>Build landing pages, case studies, and marketing collateral aligned with RCM services.</li><li>Track, analyze, and optimize marketing funnels to improve conversion rates.</li></ul>Content &amp; Thought Leadership<ul><li>Develop high-quality content including blogs, whitepapers, and LinkedIn posts focused on healthcare revenue optimization.</li><li>Collaborate with the sales and RCM teams to translate operational insights into marketing narratives.</li></ul>Performance Analytics &amp; Reporting<ul><li>Monitor KPIs such as Cost per Lead (CPL), Customer Acquisition Cost (CAC), and campaign ROI.</li><li>Use analytics tools to measure performance and provide actionable insights for improvement.</li></ul>Required Experience and SkillsIndustry Knowledge<ul><li>Strong understanding of Medical Billing and Revenue Cycle Management.</li><li>Familiarity with US healthcare reimbursement models and compliance requirements.</li></ul>Digital Marketing Expertise<ul><li>Proven experience in B2B digital marketing (preferably healthcare-focused).</li><li>Hands-on experience with SEO, PPC, LinkedIn Ads, email automation, and marketing analytics tools.</li></ul>Technical Understanding<ul><li>Basic familiarity with EHR/PMS systems such as Athenahealth, Kareo, or AdvancedMD is preferred.</li><li>Understanding of clearinghouse processes and claim workflows is a plus.</li></ul>Analytical &amp; Strategic Skills<ul><li>Ability to interpret marketing and RCM performance data.</li><li>Strong campaign optimization and conversion rate improvement skills.</li></ul>Success Metrics (KPIs)<ul><li>Increase in qualified B2B healthcare leads</li><li>Reduction in Customer Acquisition Cost (CAC)</li><li>Improved campaign ROI and conversion rates</li><li>Growth in market penetration within targeted medical specialties</li></ul>Benefits<ul><li>Opportunity to work on innovative healthcare technology initiatives</li><li>Collaborative and performance-driven work environment</li><li>Continuous professional development opportunities</li><li>Exposure to the US healthcare and RCM market</li></ul>Probation PeriodA structured three-month probation period focused on performance evaluation, strategic contribution, and long-term alignment within the organization.Job Type: Full-timeWork Location: In person

Digital Marketing Specialist – Medical Billing & (RCM)

PMTAC Pvt Ltd

Job Title: SNF Medicare Billing Specialist &ndash; PDPM (Skilled Nursing Facility)Location: Rawalpindi, Pakistan (Onsite) Company: PMTAC Pvt. Ltd. Shift: Night Shift (US Healthcare)Position OverviewPMTAC is seeking an experienced SNF Medicare Billing Specialist with strong knowledge of the Patient-Driven Payment Model (PDPM) and Skilled Nursing Facility (SNF) Medicare Part A billing requirements. The ideal candidate will have hands-on experience with MDS-driven reimbursement, HIPPS coding, and UB-04 claim submission.This role requires a strong understanding of Centers for Medicare &amp; Medicaid Services (CMS) billing guidelines and compliance regulations.Key Responsibilities1. Medicare Eligibility Verification<ul><li>Verify Medicare Part A coverage for SNF residents.</li><li>Confirm qualifying 3-day hospital stay and benefit period.</li><li>Review secondary insurance coverage (Medicaid, Medicare Advantage, commercial payers).</li></ul>2. MDS &amp; PDPM Coordination<ul><li>Review and ensure accurate completion of Minimum Data Set (MDS) assessments.</li><li>Validate:</li><li>Clinical conditions</li><li>Functional status</li><li>Comorbidities</li><li>Confirm HIPPS code generation from MDS.</li><li>Ensure documentation supports PDPM classification.</li><li>Understand and apply the guidelines of the Patient-Driven Payment Model.</li></ul>3. UB-04 (CMS-1450) Claim Preparation<ul><li>Prepare and submit facility claims using the UB-04 (CMS-1450) form.</li><li>Accurately complete required fields including:</li><li>Type of Bill (21X)</li><li>Statement Covers Period</li><li>Revenue Codes (0022&ndash;0029 for PDPM)</li><li>HIPPS Code</li><li>Units (covered days)</li><li>Total Charges</li><li>Occurrence Codes (qualifying hospital stay)</li><li>Ensure proper reporting of PDPM per diem billing structure.</li></ul>4. Claim Submission &amp; Follow-Up<ul><li>Submit claims electronically via EDI/clearinghouse or CMS DDE.</li><li>Work with Medicare Administrative Contractors (MACs).</li><li>Monitor claim status and resolve denials or RTPs.</li><li>Submit corrected claims when MDS or HIPPS codes change.</li></ul>5. Payment Reconciliation &amp; Post-Processing<ul><li>Post Medicare payments and reconcile PDPM variable per diem rates.</li><li>Identify underpayments or discrepancies.</li><li>Coordinate professional claims (CMS-1500) separately from facility billing.</li></ul>6. Compliance &amp; Audit Readiness<ul><li>Ensure clinical documentation supports billed services.</li><li>Maintain compliance with CMS and Medicare billing regulations.</li><li>Assist with audits and ADR responses.</li></ul>Required Qualifications<ul><li>Minimum 2&ndash;3 years of SNF Medicare Part A billing experience.</li><li>Strong knowledge of PDPM reimbursement methodology.</li><li>Experience working with MDS assessments and HIPPS coding.</li><li>Proficiency in UB-04 (CMS-1450) claim preparation.</li><li>Understanding of revenue codes 0022&ndash;0029.</li><li>Familiarity with Medicare Administrative Contractors (MACs).</li><li>Experience with electronic billing systems and clearinghouses.</li><li>Strong attention to detail and regulatory compliance knowledge.</li></ul>Preferred Qualifications<ul><li>RHIT, RHIA, CPC, or CPB certification.</li><li>Experience in long-term care or post-acute care settings.</li><li>Knowledge of Medicare Advantage SNF billing.</li></ul>Core Competencies<ul><li>Knowledge of PDPM case-mix components (PT, OT, SLP, Nursing, NTA).</li><li>Understanding of variable per diem adjustments.</li><li>Ability to analyze MDS-driven reimbursement.</li><li>Strong denial management skills.</li><li>Excellent documentation review and audit readiness skills.</li></ul>Interested candidates with SNF Medicare Billing Specialist are encouraged to apply by sharing their CV at: careers@pmtac.coma.arslan@pmtac.com Subject: SNF Medicare Billing SpecialistJob Type: Full-timePay: Rs80,000.00 - Rs150,000.00 per monthExperience:<ul><li>SNF Medicare PDPM billing: 2 years (Required)</li><li>MDS assessments and HIPPS coding: 2 years (Required)</li><li>UB-04 (CMS-1450) claim preparation: 2 years (Required)</li></ul>License/Certification:<ul><li>RHIT, RHIA, CPC, or CPB certification (Required)</li></ul>Location:<ul><li>Rawalpindi (Required)</li></ul>Work Location: In person

SNF Medicare Billing Specialist – PDPM (Skilled Nursing Facility)

Manipal Hospitals Goa

Key Responsibilities<ul><li>Claims Management: Prepare, review, and submit accurate insurance claims in a timely manner.</li><li>Insurance Verification: Verify patient insurance eligibility and coverage details before services are rendered.</li><li>Accounts Receivable: Follow up on unpaid, denied, or rejected claims to maximize reimbursement.</li><li>Billing Accuracy: Ensure medical coding (CPT, ICD-10) is accurate and aligns with documentation.</li><li>Patient Interaction: Address patient questions regarding statements, account status, and outstanding charges.</li><li>Compliance: Adhere to HIPAA regulations and internal financial policies.</li><li>Reporting: Generate, update, and maintain detailed, accurate billing records and reports. Indeed +8</li></ul>Required Qualifications &amp; Skills<ul><li>Education: High school diploma or GED required; Associate's degree in healthcare administration or business preferred.</li><li>Experience: 2+ years of experience in medical billing, coding, or insurance.</li><li>Technical Skills: Proficiency with billing software, EMR systems, and MS Office.</li><li>Knowledge: Strong understanding of medical terminology, ICD-10, CPT codes, and insurance guidelines (HMO/PPO).</li><li>Abilities: Excellent communication, attention to detail, problem-solving skills, and confidentiality</li></ul>Job Types: Full-time, Permanent, FresherPay: From ₹23,000.00 per monthBenefits:<ul><li>Health insurance</li><li>Leave encashment</li><li>Life insurance</li><li>Paid sick time</li><li>Provident Fund</li></ul>Work Location: In person

Associate - Billing & Insurance

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