Remote Medical Biller & AR Specialist – Oncology & Hematology (J-Codes)

We are seeking an experienced Remote Medical Biller & AR Specialist specializing in Oncology and Hematology Infusion Billing. The ideal candidate will have direct experience handling complex specialty drug billing (J-Codes), prior authorizations, and aggressive AR follow-up to maximize practice reimbursements.

Full Job Description & Duties:

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End-to-End Billing & Coding:

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Prepare, validate, and submit CMS-1500 and electronic claims for oncology, hematology, and infusion procedures.

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Apply knowledge of HCPCS Level II (J-Codes), CPT, ICD-10, and required drug units/modifiers.

2.

Accounts Receivable & Denial Resolution:

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Manage dedicated AR portfolios, following up on unpaid or aging claims across Medicare, Medicaid, and commercial payers.

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Review EOBs and ERAs to troubleshoot underpayments, medical necessity rejections, and missing authorization denials.

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Prepare and submit formal appeals with required clinical notes.

3.

Prior Authorizations & Eligibility:

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Verify patient insurance benefits and coverage guidelines for specialty infusion drugs.

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Track prior authorization status, visit limits, and expiration dates.

4.

System & Payer Portal Operations:

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Utilize EHR/EMR systems and payer portals (Availity, UHC, Cigna, Medicare) for claim tracking and documentation.

Qualifications & Requirements:

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Education: High School Graduate or Bachelor’s Degree (Healthcare/Nursing background is a plus).

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Work Experience:

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Minimum 2–3 years of U.S. Medical Billing and AR experience (Required).

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Direct experience with Oncology, Hematology, or Infusion/J-Code Billing (Required).

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Direct experience with Prior Authorizations and Denial Management (Required).

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Technical Skills: Proficient with EHR systems (EPIC, Athenahealth, OncoEMR, etc.) and Microsoft Office/Google Workspace.

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Soft Skills: Exceptional attention to detail, strong problem-solving skills, and fluent English communication.

Job Details:

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Job Type: Full-Time, Permanent

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Schedule: 8-hour shift, Night shift (U.S. hours)

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Work Remotely: Yes (Philippines-based)

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Pay Rate: $7.00