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