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Work From Home Medical Coding and Healthcare Claims Resolution Specialist
Job Summary
The Elite Job is looking for a detail-oriented and highly organized Medical Coding and Healthcare Claims Resolution Specialist to join our remote healthcare operations team. This role involves analyzing medical records, assigning accurate diagnostic and procedural codes, and resolving claims discrepancies to ensure timely reimbursement. The ideal candidate will have strong analytical skills, a deep understanding of medical terminology, and a passion for maintaining accuracy and compliance within the healthcare billing process.
As a work-from-home position, this opportunity provides flexibility while allowing you to contribute meaningfully to a fast-paced and growing healthcare support team.
Key Responsibilities
Review patient medical records and documentation to assign appropriate ICD-10, CPT, and HCPCS codes.
Audit and validate coding accuracy to ensure compliance with regulatory guidelines.
Resolve claim denials, rejections, and underpayments through analysis and resubmission.
Communicate with insurance companies, healthcare providers, and billing teams to clarify and correct discrepancies.
Maintain confidentiality and adhere to HIPAA standards for all patient data.
Track and report on claim status, denials, and coding productivity metrics.
Stay updated on coding regulations, payer requirements, and healthcare reimbursement trends.
Collaborate with team members to improve claim processing efficiency and minimize revenue loss.
Required Skills and Qualifications
Bachelors degree in Healthcare Administration, Medical Billing & Coding, or related field (preferred).
Certification from AAPC (CPC) or AHIMA (CCS, CCA) strongly preferred.
Proven experience in medical coding and healthcare claims management.
Proficiency with electronic medical record (EMR) systems and billing software.
Strong understanding of ICD-10-CM, CPT, and HCPCS Level II coding standards.
Excellent communication and problem-solving skills.
High level of attention to detail and accuracy in data entry.
Ability to work independently and meet deadlines in a remote environment.
Experience
Minimum 1–3 years of experience in medical coding, claims resolution, or healthcare billing.
Experience with Medicare, Medicaid, and private insurance claim submission and follow-up processes.
Working Hours
Flexible working schedule with core availability between 9:00 AM – 6:00 PM (local time).
Full-time or part-time remote opportunities available.
Occasional weekend or evening work may be required based on claim volume.
Knowledge, Skills, and Abilities
In-depth knowledge of healthcare reimbursement methodologies.
Strong analytical and investigative skills for claims resolution.
Ability to interpret and apply healthcare laws and payer policies.
Advanced Excel and reporting skills are an advantage.
Strong organizational abilities to manage multiple claim batches simultaneously.
Commitment to confidentiality, integrity, and ethical practices.
Benefits
100% Remote work environment.
Competitive salary with performance-based bonuses.
Health and wellness benefits package.
Paid time off, including holidays and sick leave.
Ongoing professional development and certification reimbursement.
Opportunity to work with a global healthcare services team.
Why Join The Elite Job
At The Elite Job, we believe in creating meaningful career opportunities for professionals who want to make a real difference in the healthcare industry. As part of our dynamic remote team, you will enjoy flexibility, stability, and the satisfaction of contributing to efficient healthcare operations that improve patient outcomes. We invest in our employees growth and ensure a supportive, inclusive, and collaborative environment that encourages long-term career success.
How to Apply
Interested candidates are encouraged to apply online through The Elite Jobs official career portal. Submit your updated resume, along with any relevant certifications (CPC, CCS, etc.), and a brief cover letter explaining your experience in medical coding or claims management.
Only shortlisted candidates will be contacted for an interview.
