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