[Hiring] Medical Billing & Coding Specialist @Winning Assistants

Role Description

We are seeking an experienced Medical Billing & Coding Team Lead to take ownership of critical revenue cycle functions while providing leadership, workflow oversight, and secondary office management support. This is a senior-level position and is not intended for entry-level candidates. The ideal candidate has substantial hands-on experience in U.S. medical billing and coding and can independently manage claims, coding, insurance verification, authorizations, denials, appeals, reimbursement follow-up, and patient financial communication.

Because this is a Team Lead role within a small practice, we are looking for someone who can go beyond processing assigned billing tasks. The successful candidate should be comfortable taking ownership of billing operations, identifying issues before they affect revenue, supporting other team members, improving workflows, and serving as a reliable escalation point for billing and operational concerns. Experience in outpatient physical therapy billing and coding is strongly preferred.

Key Responsibilities

• Medical Billing & Coding
  • Review clinical documentation and accurately code outpatient physical therapy services using ICD-10 and applicable billing/coding standards.
  • Ensure coding is supported by clinical documentation and complies with payer and regulatory requirements.
  • Review claims for accuracy and completeness before submission.
  • Submit clean claims promptly, with a strong emphasis on same-day claim submission when documentation is available.
  • Identify documentation or coding deficiencies and coordinate with clinicians to obtain necessary clarification.
  • Maintain a high level of billing accuracy to minimize preventable rejections, denials, and reimbursement delays.
• Revenue Cycle Management
  • Take ownership of the billing cycle from claim preparation and submission through reimbursement and account resolution.
  • Monitor outstanding claims and proactively follow up with insurance carriers.
  • Track reimbursements and identify unpaid, underpaid, rejected, or incorrectly processed claims.
  • Investigate and resolve billing discrepancies.
  • Manage claim denials, corrections, reconsiderations, and appeals.
  • Analyze recurring denial patterns and recommend process improvements to prevent future issues.
  • Support payment posting and reconciliation workflows as needed.
  • Follow up on outstanding patient and insurance balances while maintaining accurate account documentation.
  • Maintain organized billing trackers, follow-up queues, and aging reports.
• Insurance Verification & Prior Authorization
  • Verify patient insurance eligibility and benefits before services when required.
  • Confirm coverage details, deductibles, copays, coinsurance, limitations, visit allowances, and other applicable benefits.
  • Determine whether prior authorization or pre-certification is required for physical therapy services.
  • Obtain, track, and follow up on authorizations.
  • Monitor authorization expiration dates and approved visit limits to help prevent avoidable billing issues.
  • Clearly document insurance verification and authorization information within the practice management system.
• Medicare & Payer Compliance
  • Maintain working knowledge of Medicare guidelines, commercial payer policies, coding requirements, and reimbursement procedures relevant to outpatient physical therapy.
  • Monitor payer-specific billing requirements and policy changes.
  • Help ensure claims are submitted in accordance with documentation, coding, and reimbursement guidelines.
  • Identify potential compliance or reimbursement concerns and escalate them appropriately.
• Patient Financial Communication
  • Communicate professionally and compassionately with patients regarding insurance benefits and billing concerns.
  • Clearly explain estimated insurance coverage, deductibles, copays, coinsurance, outstanding balances, and patient financial responsibility.
  • Respond to patient billing inquiries and investigate account concerns.
  • Maintain a patient-centered approach when discussing sensitive financial matters.
• Insurance, Provider & Clinical Coordination
  • Communicate with insurance companies, Medicare, referring providers, patients, and clinical staff regarding claims, authorizations, documentation, and reimbursement.
  • Work directly with physical therapists and other clinical team members when documentation clarification is necessary.
  • Follow up on missing or incomplete documentation that may delay coding or claim submission.
  • Maintain thorough documentation of payer calls, claim statuses, authorization updates, appeals, and other billing activities.
• Team Lead & Workflow Oversight
  • Serve as a knowledgeable point person for medical billing and coding operations.
  • Help prioritize billing workloads and ensure time-sensitive tasks are completed promptly.
  • Support team accountability and adherence to established billing workflows.
  • Review billing processes and identify opportunities to improve efficiency, accuracy, and revenue-cycle performance.
  • Assist with troubleshooting complex claims, payer issues, coding questions, and reimbursement concerns.
  • Serve as an escalation point for difficult billing and operational matters.
  • Collaborate closely with existing team members to ensure continuity of operations and smooth handoffs.
  • Gradually assume greater ownership of billing and operational responsibilities as the current lead reduces her hours.
• Office Management & Administrative Support
  • Provide secondary office management support as needed.
  • Assist in coordinating day-to-day operational concerns that affect billing, patient service, or clinical workflows.
  • Help maintain organized processes, task tracking, and accountability across the practice.
  • Support communication between the administrative, billing, and clinical teams.
  • Assist with operational problem-solving and ensure important issues are followed through to resolution.

Qualifications

• Substantial hands-on experience in U.S. medical billing and coding is required.
• Strong proficiency in ICD-10 coding and applicable medical billing codes.
• Strong understanding of medical terminology and clinical documentation.
• Hands-on experience with:
  • Insurance eligibility and benefits verification
  • Prior authorization/pre-certification
  • Medical coding and claim preparation
  • Electronic claim submission
  • Claim status follow-up
  • Payment posting and reimbursement tracking
  • Denial management
  • Appeals and corrected claims
  • Outstanding balance and A/R follow-up
• Working knowledge of Medicare guidelines and commercial payer requirements.
• Strong understanding of the healthcare revenue cycle.
• Experience communicating directly with insurance companies, patients, healthcare providers, and clinical teams.
• Ability to review documentation critically and recognize information that may affect coding or reimbursement.
• Experience working with EHR, practice management, and medical billing platforms.
• Excellent written and verbal English communication skills.
• Strong organizational and time-management abilities.
• Exceptional attention to detail and commitment to billing accuracy.
• Ability to manage multiple priorities and deadlines independently in a remote environment.
• Demonstrated professionalism, maturity, reliability, accountability, and sound judgment.
• Ability to take ownership of a critical revenue-cycle function with minimal supervision.

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.

Technical Requirements

• 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.