Admin/Business Support (Medical Billing) - For Pooling Purposes

Job description

About this role

Experienced Medical Billing Specialists and Revenue Cycle Professionals Healthcare Virtual Assistants specializing in billing and claims management Professionals available across different schedules and time zones

Responsibilities

• Prepare, review, and submit accurate insurance claims to government and commercial payers.
• Ensure claims are submitted within required deadlines and according to payer-specific guidelines.
• Monitor claim status and proactively resolve rejected, denied, or delayed claims.
• Conduct claims follow-up to maximize reimbursements and reduce outstanding balances.
• Review explanations of benefits (EOBs), remittance advice, and payer correspondence.
• Process claim corrections, appeals, reconsiderations, and resubmissions as required.
• Manage accounts receivable (A/R) and track outstanding payments.
• Follow up on unpaid, underpaid, or denied claims.
• Analyze reimbursement trends and identify billing issues impacting revenue.
• Support end-to-end revenue cycle processes to improve collections and cash flow.
• Reconcile patient accounts, payments, adjustments, and billing records.
• Assist in reducing claim denial rates and improving reimbursement accuracy.
• Verify patient insurance coverage, benefits, authorizations, and eligibility.
• Confirm co-pays, deductibles, and patient financial responsibilities.
• Communicate with insurance companies regarding coverage questions and claim resolutions.

Qualifications and requirements

• Associate's or Bachelor's Degree in Healthcare Administration, Health Information Management, Business Administration, Medical Office Administration, or a related field preferred.
• Additional certification or formal training in Medical Billing, Medical Coding, Revenue Cycle Management, or Healthcare Administration is highly desirable.
• Minimum of 2 years of experience in medical billing, claims processing, accounts receivable, insurance verification, or revenue cycle management.
• Strong understanding of healthcare reimbursement processes and insurance claim workflows.
• Demonstrated knowledge of HIPAA regulations and handling of Protected Health Information (PHI).
• Strong knowledge of medical billing procedures and healthcare reimbursement processes.
• Working knowledge of ICD-10, CPT, and HCPCS coding systems.
• Experience managing insurance claims, denials, appeals, and collections.
• Understanding of Medicare, Medicaid, commercial insurance, and payer requirements.
• Strong attention to detail and commitment to accuracy.
• Excellent analytical, problem-solving, and troubleshooting abilities.
• Strong organizational and time-management skills.
• Excellent written and verbal communication skills.
• Ability to work independently and efficiently in a remote environment.
• Proficiency in medical billing software, EHR/EMR systems, and Microsoft Excel.
• Ability to manage multiple priorities while meeting performance and turnaround targets.