Medical Billing & Claims Specialist

Job Title: Medical Billing & Claims Specialist

Position type: Full-Time

Work hours: 8:00 AM to 5:00 PM Central Daylight Time (final schedule might change)

Work days: Monday to Friday

Salary: $5 - $7 per hour, depending on experience

Workplace: Remote

Our client is a well-established U.S.-based allergy and immunology medical practice seeking an experienced and detail-oriented Medical Billing & Claims Specialist to support its existing in-house billing team.

This role is primarily focused on claims posting, claims management, denial management, and billing support. You will work with a steady volume of medical claims and help ensure they are processed accurately, efficiently, and in compliance with established billing procedures.

The ideal candidate has at least 2-3 years of hands-on medical billing experience, with strong experience in both claims posting and claims management for medical procedures. You should be comfortable investigating denied claims, handling complex billing scenarios, and following claims through resolution and payment.

Training will be provided for the practice's systems, ModuleMD and RXNT, so candidates with strong medical billing experience using other platforms are also encouraged to apply.

Key Responsibilities

Claims Posting & Management

• Post and process medical claims accurately and efficiently
• Manage claims related to medical procedures from submission through resolution
• Review claims for completeness and accuracy before processing
• Maintain accurate posting and billing records
• Manage a consistent daily volume of claims while maintaining quality and accuracy
• Track claim status and follow up on outstanding claims
• Help ensure claims are processed according to established billing and compliance requirements

Denial Management & Follow-Up

• Review and work denied or rejected claims
• Identify reasons for denials and take appropriate corrective action
• Resubmit or follow up on claims as necessary
• Work toward successful claim overturns and reimbursement
• Document denial actions and claim follow-up accurately
• Identify recurring billing or denial issues when appropriate

Medical Billing Support

• Provide billing support to the existing in-house billing team
• Assist with complex billing scenarios, including situations involving multiple patient reimbursements
• Review payer information and billing documentation as needed
• Maintain organized and accurate billing records
• Follow established compliance and confidentiality requirements
• Assist with additional billing-related responsibilities as assigned

Performance Expectations

Performance will be evaluated based on factors such as:

• Number of claims accurately processed and posted
• Accuracy of claims posting
• Productivity and ability to manage the expected daily claims volume
• Number and percentage of denied claims successfully overturned or paid
• Quality and accuracy of billing documentation
• Consistency in meeting established claims-processing goals

The practice is targeting strong productivity in claims processing, with an expectation of working toward at least 80 claims posted per day and approximately 85-90% successful resolution/payment of worked claims, where applicable.

Requirements

Required Skills & Experience

• Minimum 2-3 years of medical billing experience
• Hands-on claims posting experience is required
• Strong experience managing claims for medical procedures is required
• Experience working denied and rejected claims through resolution
• Strong understanding of the medical billing and claims lifecycle
• Ability to investigate claim issues and determine appropriate next steps
• Experience handling complex billing scenarios
• Strong understanding of billing accuracy, compliance, and confidentiality requirements
• Ability to manage a high volume of claims while maintaining accuracy
• Strong attention to detail and organizational skills
• Able to work independently and consistently meet productivity expectations
• Clear and professional written and spoken English
• Reliable, accountable, and comfortable working as part of an established billing team

Preferred Experience

• Experience using ModuleMD
• Experience using RXNT
• Previous experience supporting a U.S.-based medical practice
• Experience working with specialty medical billing
• Experience managing high-volume claims
• Demonstrated success working denied claims and obtaining reimbursement

ModuleMD and RXNT experience is preferred but not required. Training will be provided, and experienced medical billers who have worked with other billing, practice management, or EHR systems are encouraged to apply.

Basic 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.

These are optional resources and client-approved allowances available to you as an independent contractor. Any resources, training, or allowances listed are optional contractor perks and not employee benefits.