Medical Billing, Prior Authorization Specialist

🔥 52 minutes ago

🇵🇭 Philippines – Remote

💵 $10.4k - $14.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🏥 Medical Billing and Coding

👻 Ghost score 15%

What it means: the chance that no one is really hiring for this job.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 and process approximately 20–30 US healthcare insurance claims daily • Review billing information, insurance coverage, provider details, and documentation before claim submission • Identify and resolve billing discrepancies, rejected claims, and processing issues • Ensure accurate billing for psychologists, psychiatrists, and doctoral interns • Coordinate with insurance companies to resolve claim concerns and maintain reimbursement workflows • Handle prior authorization requests for behavioral health and psychiatric services • Verify insurance requirements, coverage limitations, and authorization status • Coordinate with providers, insurers, and internal staff to obtain documentation • Track pending authorizations and follow up on outstanding requests • Maintain records of authorization approvals, denials, and expiration dates • Follow up on unpaid, pending, rejected, or denied claims • Maintain organized billing records and track outstanding tasks • Assist with billing procedures and administrative workflow improvements • Collaborate with the billing specialist and clinical team • Communicate with clinics, insurance representatives, and patients • Explain insurance benefits, coverage, and billing responsibilities to patients • Provide clinic service information and handle inquiries • Handle inbound and outbound calls using RingCentral • Support additional administrative responsibilities as assigned

🎯 Requirements

• Must have previous hands-on experience with US healthcare insurance billing and claims processing • Experience handling insurance claims submissions, billing follow-ups, and resolving claim discrepancies • Knowledge of prior authorization workflows, insurance eligibility, and benefits verification • Familiarity with US healthcare billing procedures, payer requirements, and insurance terminology • Strong attention to detail • Excellent organizational skills and ability to manage multiple tasks and deadlines independently • Strong verbal communication skills with clear, easily understandable spoken English • Proficiency in speaking and writing English clearly and professionally • Must be comfortable communicating with US patients, insurance representatives, and healthcare professionals • Must submit an NBI Clearance and/or Local Police Clearance before onboarding • Must be available during US Central Time business hours and for occasional weekend follow-ups • Must follow HIPAA guidelines and maintain patient information confidentiality • Reliable computer with minimum 25 Mbps stable high-speed internet • Noise-canceling headset, working webcam, and quiet professional workspace • Experience in psychology, psychiatry, or behavioral health billing highly preferred • Experience with TherapyNotes, Tebra, RingCentral, or similar healthcare systems is advantageous • Previous remote or healthcare virtual assistant experience preferred but not mandatory

🏖️ 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 • Flexible remote work arrangement

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