[Hiring] Medical Biller @RCM Staff LLC

Role Description

This is a remote position.

RCM Staff BPO is hiring a part-time Medical Billing and Prior Authorization Specialist to support an orthopedic spine surgery practice. The specialist will handle:

• Prior authorizations for surgical cases
• Verify eligibility and benefits
• Submit claims
• Work denials and A/R
• Post payments for a single-provider practice

The specialist is responsible for:

• Getting clean claims out
• Authorizations approved before the case
• Resolving denied or unpaid claims

This role requires hands-on orthopedic or spine billing experience and strong follow-through, including:

• Strong attention to detail
• Consistent follow-up
• Experience working with U.S. health insurance plans

Qualifications

• At least 2 years of experience with U.S. healthcare insurance
• Hands-on medical billing experience for an orthopedic or spine surgery practice, including prior authorizations for surgical procedures
• Familiarity with commercial insurance and government health plans
• Experience using payer portals and insurance websites
• Strong written and spoken English, including comfort speaking with payers and patients by phone
• Excellent attention to detail and follow-up skills
• Ability to work independently and manage multiple patient accounts
• Reliable internet connection and a suitable remote workspace

Requirements

• Experience supporting spine surgery, orthopedic surgery, or pain management practices
• Experience with surgical prior authorizations through delegated review vendors such as Carelon or eviCore
• Experience with workers' compensation billing and authorization
• Understanding of surgical global periods, modifiers, and add-on codes for spine procedures
• Familiarity with Georgia insurance plans, including Medicare (Palmetto GBA), Georgia Medicaid and CMOs, and TRICARE East
• Willingness to learn a new EHR and practice management system, as the practice is implementing a new platform

Schedule

• Part-time position for 90 days, approximately 20 hours per week (4 hours per day), with the possibility of moving to full-time after
• Must be available during Eastern Time business hours
• Final schedule will be determined based on practice needs