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Medical Billing Specialist - Virtual Assistant

Manila, PHNa miejscuUmowaPełny etat

Opublikowano 14 sie 2026

To stanowisko jest opublikowane w języku EN

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.



Przegląd stanowiska

Typ stanowiska

Pełny etat

Wymagane umiejętności

US medical billing (including substantive out-of-network claim submission)Claims submission, claim scrubbing, and end-to-end claim tracking to paymentERA posting and payment reconciliation, including identifying and quantifying underpaymentsAppeals and denial management (build and pursue first-level and escalated appeals)Insurance verification and use of eligibility portals/clearinghouses (e.g., Availity, ClaimMD)Practice management / EMR software operation (Practice Pro, IntakeQ)Advanced Excel / Google Sheets for building reconciliations and aging reportsPediatric therapy billing knowledge (OT/PT/SLP CPT ranges, timed vs. untimed codes, 8-minute rule, treatment vs. evaluation codes)Authorization-driven care management and unit trackingManaged Care Organization (MCO) and Medicaid-secondary billing experiencePatient account management including payment plans, collections communication, and empathetic family-facing interactionsAccurate documentation and recordkeeping of payer conversations (date, representative, reference number, outcome)Caseload management for high-volume recurring schedules (manage 200+ active patients)Professional verbal and written communication with US payers and families (phone/phone-based negotiation)Independent problem-solving, persistence in follow-up, and sound escalation judgment

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