Medical Billing & Insurance Specialist

🔥 2 hours ago

🇵🇭 Philippines – Remote

💵 $10.4k - $12.5k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🏥 Medical Billing and Coding

👻 Ghost score 11%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Winning Assistants LLC

WebsiteLinkedInAll Job Openings

51 - 200 employees

💼 Consulting

📣 Marketing

📦 Logistics

Consulting • Marketing • Logistics

Winning Assistants LLC is a staffing and recruiting company that provides virtual assistants from the top 1% of the global talent pool. They specialize in helping doctors, healthcare professionals, and business owners save time, reduce costs, and scale operations with highly skilled, HIPAA-compliant virtual assistants. Their services include admin support, medical office management, marketing, and customer service, allowing clients to focus on growth.

📋 Description

• 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 • Verify patient eligibility, benefits, and coverage • Work with vision insurance plans, Blue Cross/Blue Shield, UnitedHealthcare, Aetna, Medicare, and Medicaid • Navigate payer portals, particularly Availity • Complete insurance verification with an approximately 10-minute turnaround target • Document coverage, benefits, and relevant insurance information • Review and scrub claims before submission • Confirm diagnosis codes support corresponding CPT/procedure codes • Identify 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 • Work closely with the medical scribe and other Virtual Assistants • Maintain accurate and HIPAA-compliant patient and billing documentation • Communicate billing or insurance issues clearly with 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

🎯 Requirements

• 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 • Ability to identify billing or coding issues that could result in denials or delayed reimbursement • Strong attention to detail, accuracy, organization, and follow-through • 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 • Reliable laptop or desktop computer • Stable high-speed internet connection, minimum 25 Mbps • Noise-canceling headset • Working webcam for virtual meetings • Quiet and professional work environment • TriZetto experience preferred but not required • i-Pegasus experience is a plus but not required; training will be provided • Optometry or ophthalmology billing experience is a plus but not required • Previous remote or Virtual Assistant experience preferred but not required • Medical or healthcare degree not required • Active medical license not required • Relevant professional medical billing experience is more important than a specific medical degree or license

🏖️ Benefits

• Dedicated HR & Contractor Support Team • Premium VPN Access (Optional) • HIPAA & Cybersecurity Training + Certification (Provided) • Top 1% VA Performance Training • Client-Approved U.S. Holidays • Client-Approved Paid or Unpaid Time Off • Access to Tools & Resources • Optional Performance-Based Incentives • Optional contractor perks and client-approved allowances