We are seeking a detail-oriented and experienced Medical Biller specializing in denials management and accounts receivable (AR) follow-up within general surgery. This role is responsible for driving timely resolution of denied, rejected, and underpaid claims, ensuring maximum reimbursement and minimizing outstanding AR.
The ideal candidate has strong expertise in EPIC EMR, a deep understanding of surgical billing workflows, and a proactive approach to identifying and resolving claim issues.
Key Responsibilities
- Perform high-volume follow-up on denied, rejected, and underpaid claims for general surgery services
- Analyze denials to identify root causes and implement corrective actions for resolution
- Prepare and submit appeals, reconsiderations, and corrected claims with appropriate documentation
- Manage claims throughout the full lifecycle—from denial through resolution and readiness for payment posting
- Utilize EPIC EMR to review claim status, document actions, and track follow-up activities
- Communicate with insurance payers via phone and online portals to resolve claim discrepancies
- Identify denial trends and escalate recurring or systemic issues to leadership
- Collaborate with coding, front-end, and authorization teams to reduce future denials
- Ensure compliance with payer guidelines, billing regulations, and timely filing requirements
- Maintain accurate and detailed documentation of all follow-up and resolution efforts
Qualifications
- 2–4+ years of medical billing experience, with a focus on denials and AR follow-up
- Proven experience in general surgery billing (required)
- Hands-on experience with EPIC EMR (required)
- Strong understanding of EOBs, ERAs, and payer denial codes
- Experience working with commercial, Medicare, and Medicaid payers
- Familiarity with payer portals and claims management systems
- Solid knowledge of CPT, ICD-10, and modifiers related to surgical billing
- Experience handling appeals and grievance processes for surgical claims
- Background in multi-specialty or high-volume surgical environments
- Familiarity with denial tracking, reporting, and KPI monitoring
Perks
- Permanent Work From Home
- Leave Credits
- Monetary Allowance
- Annual Bonus
- Weekly Paychecks
- Fixed Weekends Off
- Thriving Company Culture with Complete Autonomy
- Exclusive Specialized Training Programs
- Unlock Your Potential with a Highly Competitive Salary
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Who are we
MedCore Solutions is the healthcare division of BizForce, dedicated to supporting U.S.-based healthcare clients through a skilled remote workforce in the Philippines. We specialize in connecting top clinical and administrative talent with reputable healthcare organizations, ensuring high-quality care delivery while providing rewarding work-from-home careers.
