[Hiring] Medical Billing & Insurance Specialist @Winning Assistants

Role Description

Our client is looking for an experienced Medical Billing & Insurance Specialist with strong hands-on experience in full-cycle medical billing, insurance verification, claims management, and revenue cycle management. This is not an entry-level or training-only billing position. Candidates must have actual professional experience handling medical claims, denials, insurance verification, and payer portals.

Top 3 Priorities

• Full-Cycle Medical Billing & Revenue Cycle Management
  • Manage claims throughout the complete billing cycle.
  • Prepare, review, and submit accurate claims.
  • Monitor claim status and follow up on outstanding or unpaid claims.
  • Investigate and resolve rejected and denied claims.
  • Handle appeals and communicate with insurance companies as needed.
  • Identify billing issues that may delay or prevent reimbursement.
  • Maintain accurate billing records and support a healthy revenue cycle.
• Insurance Verification
  • Verify patient eligibility, benefits, and coverage accurately and efficiently.
  • Work primarily with vision insurance plans, Blue Cross/Blue Shield, UnitedHealthcare, Aetna, Medicare, and Medicaid.
  • Navigate payer portals, particularly Availity, to obtain insurance information.
  • Complete insurance verification efficiently, with a target turnaround time of approximately 10 minutes per verification.
  • Accurately document coverage, benefits, and relevant insurance information.
• Medical Coding & Claims Scrubbing
  • Review and scrub claims before submission to identify errors or missing information.
  • Confirm that the appropriate diagnosis codes support the corresponding CPT/procedure codes for reimbursement.
  • Identify potential coding-related issues that could lead to claim denials or delayed payments.
  • Support clean and accurate claim submissions.
  • Follow the practice’s coding and billing guidelines; clinic-specific training will be provided.

Additional Responsibilities

• Work closely with the practice's medical scribe and other Virtual Assistants to support billing and administrative workflows.
• Maintain accurate and HIPAA-compliant patient and billing documentation.
• Communicate billing or insurance issues clearly with the appropriate team members.
• Follow established clinic SOPs and billing processes.
• Participate in training with the clinic team and outgoing medical biller to ensure a smooth transition.

Qualifications

• Solid hands-on medical billing experience; training or certification alone does not qualify.
• Experience managing full-cycle medical billing and revenue cycle management (RCM).
• Strong experience with medical claim preparation, submission, and follow-up.
• Hands-on experience resolving claim denials and rejections and handling appeals.
• Strong insurance eligibility and benefits verification experience.
• Proficiency with Availity is required.
• Experience navigating insurance/payer portals.
• Experience working with commercial and/or government insurance plans such as Blue Cross/Blue Shield, UnitedHealthcare, Aetna, Medicare, and Medicaid.
• Working knowledge of ICD-10, CPT codes, claim scrubbing, and medical coding principles as they relate to billing and reimbursement.
• Ability to identify billing or coding issues that could result in denials or delayed reimbursement.
• Strong attention to detail, accuracy, organization, and follow-through.

Requirements

• Excellent written and spoken English.
• Comfortable communicating with insurance companies and internal team members.
• Ability to work independently while collaborating closely with the clinic team.
• Ability to learn and follow clinic-specific billing SOPs.
• Strong understanding of patient confidentiality and HIPAA requirements.
• Must be able to submit an NBI Clearance and/or Local Police Clearance before onboarding.
• Must be available for video meetings with the 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.