Medical Billing & Claims Specialist

This is a fully remote position, open to applicants in Philippines.

📋 Description

• Accurately process and submit medical claims in a timely manner.

• Follow up on pending claims with insurance providers.

• Investigate and resolve claims that have been denied, rejected, or remain unpaid.

• Monitor claim status to ensure appropriate reimbursement is obtained.

• Analyze Explanation of Benefits (EOBs) and payment postings.

• Confirm patient insurance eligibility and benefits.

• Submit and oversee prior authorizations (pre-auths).

• Collaborate with providers, insurance companies, and patients regarding billing issues.

• Keep accurate billing documentation and records.

• Provide administrative support as needed.

• Assist with general administrative and clerical duties.

• Maintain and update patient records and databases.

• Handle emails and correspondence related to billing.

• Support scheduling and various operational workflows as required.

• Help with reporting and documentation requests.

⛳️ Requirements

• Prior experience in medical billing and claims processing is essential.

• Strong knowledge of insurance verification, claims follow-up, denial management, and prior authorizations.

• Experience with Availity is highly preferred.

• Familiarity with EMR/EHR systems and medical billing software is required.

• Exceptional attention to detail and strong organizational skills are necessary.

• Proficient written and verbal communication skills are essential.

• Ability to work independently while managing multiple priorities is important.

• Must be comfortable in a fast-paced healthcare environment.

• Preferred Experience includes:

• Medical Billing

• Revenue Cycle Management (RCM)

• Insurance Verification

• Prior Authorizations

• Claims Follow-Up

• Denials & Appeals

• Availity

• Healthcare Administration

• Patient Coordination

🏝️ Benefits

• Dedicated HR & Contractor Support Team: Access to world-class support for questions, guidance, contract matters, and client communication.

• Premium VPN Access (Optional): A secure VPN license can be provided upon request to enhance privacy and security for client-related tasks.

• HIPAA & Cybersecurity Training + Certification (Provided): Access to our internal HIPAA compliance training, cybersecurity modules, and certification to help you confidently handle PHI for U.S. healthcare clients.

• Top 1% VA Performance Training: Access to our proprietary training on communication, client management, productivity systems, and best practices to help you become a top-performing VA and increase long-term client retention.

• Client-Approved U.S. Holidays: Contractors may take U.S. holidays off according to the client’s needs and schedule.

• Client-Approved Paid or Unpaid Time Off: Time off may be granted by your client. Paid time off is optional and only if offered by the client.

• Access to Tools & Resources: Templates, workflow guides, productivity tools, and client-specific SOP support to help you perform at your best.

• Optional Performance-Based Incentives: Some clients may offer bonuses, incentives, or increased hours based on your performance.