About the role
Rex.zone is hiring Brazil-based professionals to support US healthcare revenue cycle workflows. You will perform compliant medical coding and billing operations, resolve claim edits and denials, and help improve clean-claim rate and reimbursement outcomes while working full-time remotely.
Key Responsibilities
- Assign ICD-10-CM, CPT, and HCPCS codes based on provider documentation and payer rules
- Audit charts for documentation completeness and coding compliance
- Perform charge entry, claim creation, and claim submission via clearinghouse
- Review EOB/ERA, post payments, and reconcile adjustments
- Analyze denials (eligibility, authorization, bundling, medical necessity) and submit appeals
- Work A/R follow-up queues to reduce aging and improve collections
- Verify eligibility, benefits, and prior authorization requirements
- Maintain HIPAA-aware handling of PHI and follow internal SOPs/QA checklists
- Provide status updates and KPI reporting (clean-claim rate, denial rate, A/R aging)
Required Qualifications
- Mid-to-senior experience in US medical billing and/or medical coding
- Strong working knowledge of ICD-10-CM, CPT, and HCPCS for claims
- Familiarity with payer policies, NCCI edits, modifiers, and medical necessity rules (LCD/NCD)
- Experience across claim lifecycle: submission, rejections, denials, appeals, payment posting, A/R follow-up
- Ability to work full-time remotely from Brazil with reliable internet and secure work practices
Workplace This is a Remote role intended for candidates based in Brazil, supporting US healthcare operations across time zones when needed.
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