[Hiring] Medical Billing & Claims Specialist @Winning Assistants

Role Description

Our client is a well-established U.S.-based allergy and immunology medical practice seeking an experienced and detail-oriented Medical Billing & Claims Specialist to support its existing in-house billing team. This role is primarily focused on claims posting, claims management, denial management, and billing support.

• Post and process medical claims accurately and efficiently
• Manage claims related to medical procedures from submission through resolution
• Review claims for completeness and accuracy before processing
• Maintain accurate posting and billing records
• Manage a consistent daily volume of claims while maintaining quality and accuracy
• Track claim status and follow up on outstanding claims
• Help ensure claims are processed according to established billing and compliance requirements
• Review and work denied or rejected claims
• Identify reasons for denials and take appropriate corrective action
• Resubmit or follow up on claims as necessary
• Work toward successful claim overturns and reimbursement
• Document denial actions and claim follow-up accurately
• Identify recurring billing or denial issues when appropriate
• Provide billing support to the existing in-house billing team
• Assist with complex billing scenarios, including situations involving multiple patient reimbursements
• Review payer information and billing documentation as needed
• Maintain organized and accurate billing records
• Follow established compliance and confidentiality requirements
• Assist with additional billing-related responsibilities as assigned

Performance will be evaluated based on factors such as:

• Number of claims accurately processed and posted
• Accuracy of claims posting
• Productivity and ability to manage the expected daily claims volume
• Number and percentage of denied claims successfully overturned or paid
• Quality and accuracy of billing documentation
• Consistency in meeting established claims-processing goals

Qualifications

• Minimum 2–3 years of medical billing experience
• Hands-on claims posting experience is required
• Strong experience managing claims for medical procedures is required
• Experience working denied and rejected claims through resolution
• Strong understanding of the medical billing and claims lifecycle
• Ability to investigate claim issues and determine appropriate next steps
• Experience handling complex billing scenarios
• Strong understanding of billing accuracy, compliance, and confidentiality requirements
• Ability to manage a high volume of claims while maintaining accuracy
• Strong attention to detail and organizational skills
• Able to work independently and consistently meet productivity expectations
• Clear and professional written and spoken English
• Reliable, accountable, and comfortable working as part of an established billing team

Requirements

• Must speak and write English clearly and professionally
• Must have relevant work experience
• Must be able to provide an NBI Clearance and/or Local Police Clearance before onboarding (mandatory)
• Must be available to attend video meetings with camera on when required
• Computer: Reliable laptop or desktop computer
• Internet: Stable high-speed internet connection (minimum 25 Mbps)
• Audio: Noise-canceling headset
• Video: Working webcam for virtual meetings
• Workspace: Quiet and professional work environment

Benefits

• Dedicated HR & Contractor Support Team: Access to world-class support for questions, guidance, contract matters, and client communication
• Premium VPN Access (Optional): A secure VPN license can be provided upon request to enhance privacy and security for client-related tasks
• HIPAA & Cybersecurity Training + Certification (Provided): Access to our internal HIPAA compliance training, cybersecurity modules, and certification to help you confidently handle PHI for U.S. healthcare clients
• Top 1% VA Performance Training: Access to our proprietary training on communication, client management, productivity systems, and best practices to help you become a top-performing VA and increase long-term client retention
• Client-Approved U.S. Holidays: Contractors may take U.S. holidays off according to the client’s needs and schedule
• Client-Approved Paid or Unpaid Time Off: Time off may be granted by your client. Paid time off is optional and only if offered by the client
• Access to Tools & Resources: Templates, workflow guides, productivity tools, and client-specific SOP support to help you perform at your best
• Optional Performance-Based Incentives: Some clients may offer bonuses, incentives, or increased hours based on your performance