Senior Medical Biller​/Coder- eClinicalWorks, Cardiology & GI

Position: Senior Medical Biller / Coder- eClinicalWorks, Cardiology & GI
Location :
Remote
- India
Shift : US Eastern Time overlap required
Experience :
Minimum 5 years of US healthcare billing/coding experience
Specialties :
Cardiology and Gastroenterology initially;
Ambulatory Surgery Center (ASC) later
EHR Requirement :
Strong hands-on eClinical

Works (eCW) experience required

Employment Type

:
Full-time

Role Overview
We are looking for an experienced  Medical Biller / Coder  with strong hands-on experience using  eClinical

Works (eCW)  for US physician-practice billing.

The ideal candidate should have at least  5 years of US medical billing and coding experience , preferably supporting Cardiology and/or Gastroenterology practices.

This is not a basic charge-entry position. We are looking for someone who understands the complete revenue cycle and can independently review documentation, coding, claims, rejections, denials, payment issues, and accounts receivable.

The role will initially support our  Cardiology and Gastroenterology   practices  and will subsequently expand to support an  Ambulatory Surgery Center (ASC) .

Key Responsibilities
eClinical

Works Billing
Perform day-to-day billing activities directly within eClinical

Works (eCW).
Review encounters and ensure charges are entered correctly.
Review claims before submission.
Work eCW billing work queues.
Review claim edits and clearinghouse rejections.
Correct rejected claims and resubmit them.
Review claim status within eCW and payer systems.
Review patient and insurance information for billing accuracy.
Review ERA/EOB information.
Work outstanding A/R from eCW reports.
Maintain appropriate account and claim notes.
Run and interpret billing, aging, payment, denial, and productivity reports.
Identify workflow or configuration issues that may be affecting clean claim submission.
Coordinate with front desk, clinical staff, referral staff, and providers when billing information is incomplete.

Candidates must have genuine hands-on eCW billing experience and should be comfortable navigating the billing module independently.

Coding Responsibilities
Review clinical documentation and assign appropriate:
-- ICD-10-CM
-- CPT
-- HCPCS
-- Modifiers

Review coding for completeness and medical necessity.
Identify documentation deficiencies before claims are submitted.
Review E/M coding where applicable.
Validate procedure and diagnosis combinations.
Review modifier usage.
Identify bundling or unbundling concerns.
Review payer-specific coding requirements.
Ensure billed services accurately reflect the physician documentation.

Claims & Denial Management
Submit clean claims electronically.
Review clearinghouse and payer rejections.
Correct and resubmit rejected claims.
Investigate denied claims.
Determine root cause of denials.
Submit corrected claims.
Prepare reconsiderations and appeals.
Follow up with insurance carriers.
Review authorization-related denials.
Review eligibility-related denials.
Identify coding and modifier-related denials.
Identify medical-necessity denials.
Track recurring denial patterns.
Recommend workflow changes to reduce repeat denials.

The candidate should not simply work denial queues but should be able to explain  why the denial occurred and how to prevent it from occurring again .

Accounts Receivable
Work insurance A/R.
Follow up on unpaid and underpaid claims.
Review aging buckets.
Prioritize high-value and high-risk accounts.
Contact payers regarding outstanding claims.
Review payer portals and claim status.
Identify claims approaching filing deadlines.
Follow up on appeals and reconsiderations.
Document all follow-up activity accurately.
Identify systemic A/R issues and escalate them.

Required Qualifications
Minimum 5 years of US medical billing and coding experience.
Strong hands-on eClinical

Works billing experience.
Ability to independently navigate…