Virtual Medical Biller & Revenue Cycle Specialist

7 hours, 44 minutes ago
Full-time
Junior
Operations
Staffing For Doctors

Staffing For Doctors

Staffing For Doctors provides virtual medical staffing solutions for healthcare practices, connecting them with top HIPAA-compliant candidates to enhance operational efficiency, reduce overhead costs, and improve patient care through dedicated virtual ...

Health Care Providers & Services
Founded 2025

Description

  • Review, scrub, and electronically submit medical claims in a timely manner while maintaining compliance with payer policies.
  • Audit clinical documentation to verify CPT modifiers, ICD-10 codes, and procedural coding combinations for surgical claims.
  • Catch and resolve billing errors before clearinghouse submission to support a high first-pass clean claim rate.
  • Monitor claim statuses, investigate denials, correct rejections, and appeal underpaid or denied claims aggressively.
  • Track insurance aging reports and accounts receivable balances to reduce outstanding days in A/R.
  • Identify systemic underpayment patterns and payer friction points, then recommend workflow improvements to support collections.
  • Verify complex in-network and out-of-network patient insurance details, including deductibles, coinsurance, and surgical caps.
  • Cross-check prior authorizations and referrals against the patient chart and scheduled surgical CPT codes.
  • Communicate with commercial insurance carriers and Medicare to resolve claim bottlenecks and insurance discrepancies.
  • Support patients by explaining billing statements, insurance allocations, and balances during escalated inquiries.

Requirements

  • Minimum 2+ years of dedicated U.S. medical billing experience with full-cycle revenue management responsibility.
  • Proven experience in a surgical or specialty medical practice with multi-tier surgical coding rules.
  • Deep understanding of in-network and out-of-network insurance models, commercial payers, and Medicare.
  • Dedicated, secure home office setup compliant with HIPAA privacy protocols.
  • High-speed internet and a dual-monitor environment preferred.
  • Direct hands-on billing experience in bariatric surgery, general surgery, or medical aesthetics preferred.
  • Advanced technical fluency with the Practice Fusion EMR ecosystem preferred.
  • Knowledge of surgical bundling, multiple procedure modifiers such as Modifier 51 and 59, and assistant surgeon billing preferred.

Interested in this position?

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