About the medical billing specialist role
Medical billing at CredSpun is not a single step on a production line. Each billing specialist is assigned to a small group of outpatient practices — family medicine, behavioral health, psychiatry, pediatrics, nurse practitioner and specialty clinics — and works their claims across the whole cycle. You know the practice's payer mix, its fee schedule and the denials it tends to see, so problems are caught before a claim goes out rather than after it comes back.
You will work directly in the client's EHR and practice management system and in their clearinghouse. The practice's account lead is your first point of contact, and you will join the fortnightly status calls where we walk the practice through its numbers.
What you will do
- Review charges for completeness and match CPT, HCPCS, ICD-10-CM codes and modifiers to the visit
- Scrub and submit professional claims (CMS-1500 / 837P) electronically through the practice's clearinghouse
- Work clearinghouse and payer rejections the same day so claims are accepted on first pass
- Post ERA and paper EOB payments line by line and flag underpayments against the contracted rate
- Follow up on unpaid claims by portal and phone, and document every touch in the PM system
- Prepare corrected claims and secondary claims, including Medicare crossovers
- Answer patient balance questions clearly and set up statements
- Note recurring errors and pass them to the account lead so they are fixed at the front desk
What you need
- Two or more years of medical billing experience for U.S. physician or outpatient practices
- Working knowledge of CPT, ICD-10-CM, HCPCS and common modifiers (25, 59, 95, GT and the like)
- Experience with Medicare, Medicaid and commercial payers, including payer portals
- Comfort reading an EOB/ERA and recognising CARC and RARC codes
- Clear written English for claim notes, appeals and patient messages
- Accuracy under deadline and the habit of documenting what you did
Helpful, not required
A billing credential such as CPB (AAPC) or CRCR (HFMA); experience in athenahealth, eClinicalWorks, Tebra / Kareo, AdvancedMD, SimplePractice or DrChrono; and some exposure to behavioral health or telehealth billing rules.
Working remotely at CredSpun
This is a fully remote, work-from-home role open to applicants living in the United States. You work during U.S. business hours alongside a named account team, inside each client practice's own EHR and practice management system, with every login tied to you personally. You need a quiet, private workspace, a reliable broadband connection and a computer that can run a current browser and a second monitor. HIPAA training is part of onboarding, and you sign our confidentiality terms before you are given access to any patient data.