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
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Mission-Driven: Focused on helping children and families thrive.
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Solution-Oriented: Encourages independent problem-solving and continuous improvement.
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Team-Centered: Every member is essential to the success of the clinic.
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Growth-Focused: Mistakes are viewed as opportunities to learn and get better.
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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