Medical Billing Specialist - Virtual Assistant

### This is a remote position. **Rockstar** is seeking a dedicated and detail-oriented Medical Billing Specialist to join our partner’s growing healthcare practice. This is a full-time position focused on billing, claim management, insurance verification, and client communication. The ideal candidate will have strong billing experience, thrive in a fast-paced environment, and ensure accuracy and efficiency in financial processes. If you're proactive, organized, and have a strong understanding of medical billing and insurance processes, this is a great opportunity to join a collaborative, fast-paced team making a real impact. ### About the Clinic's Culture * Mission-Driven: Focused on helping children and families thrive. * Solution-Oriented: Encourages independent problem-solving and continuous improvement. * Team-Centered: Every member is essential to the success of the clinic. * Growth-Focused: Mistakes are viewed as opportunities to learn and get better. * Efficiency-Minded: The team is always seeking ways to work smarter.​ ### What You Will Actually Do _**Benefits & Reimbursement**_ * Track and chase EOBs from BCBS families * Distinguish clearly between coded claims and self-pay receipts, and understand why the distinction matters legally and financially * Navigate in-network billing for three additional insurances, two of which routinely require issue-sorting and investigation _**Claims & Revenue Cycle**_ * Review charges for accuracy and completeness before submission; catch coding, modifier, unit, and eligibility errors upstream rather than after denial * Submit, scrub, and track claims through to payment * Post ERAs and reconcile payments; identify underpayments against expected reimbursement rather than simply posting what arrived * Build and pursue appeals, first level and beyond, with supporting documentation _**Accounts & Families**_ * Manage patient balances, payment plans, and collections communication with professionalism and empathy, these are families with children in therapy, tone matters * Resolve disputes and discrepancies independently, escalating only what genuinely requires the Revenue Cycle Manager or owner * Maintain documentation of every payer conversation: date, representative, reference number, outcome * Work with the on-site admin team to ensure account issues are resolved when patients arrive for appointments, and provide education to staff and families as needed ### Software Used * Practice Pro * ClaimMD * Availity * IntakeQ * Microsoft Office 365 * Zoom (phone, chat, video) ### Requirements ### Required Experience — Non-Negotiable * Minimum 3 years of US medical billing experience, with at least 1 year of substantive out-of-network work. Candidates whose experience is exclusively in-network claim submission will not be a fit * Demonstrated ability to manage a caseload of 200+ active patients with recurring visit schedules * Working command of eligibility portals and clearinghouses (Availity, ClaimMD, or equivalent), and EMR/practice management systems * Fluent, professional written and spoken English, you will speak directly with US payers and US families by phone * Comfortable working US Eastern business hours * Strong Excel/Google Sheets skills, able to build a reconciliation or aging report, not just read one ### Strongly Preferred * Pediatric therapy billing (OT, PT, SLP), therapy CPT ranges, timed vs. untimed codes, the 8-minute rule, treatment vs. evaluation codes * Experience with authorization-driven care and unit tracking * Managed care organization (MCO) and Medicaid-secondary experience * Prior experience in a small practice where you were the one who figured it out ### The Kind of Person This Works For * Independent. You research the answer before you ask. You bring recommendations, not open questions * Persistent. You will call a payer three times about the same claim and stay pleasant on the third call * Organized under load. Dozens of moving accounts, none of which can be dropped * Direct. You tell us when something is wrong or when you are behind, early * Discreet. Full HIPAA compliance is assumed, not celebrated ### Benefits * Competitive salary commensurate with experience. * Opportunities for professional development and growth. * Work in a dynamic and supportive team environment. * Make a meaningful impact by helping to build and strengthen families across the globe. Originally posted on [Himalayas](https://himalayas.app)