Medical Billing Specialist - Virtual Assistant

This is a remote position.

Rockstaris hiring a full-time Medical Billing Specialist - Virtual Assistanton behalf of an outpatient pediatric therapy practice.

This role provides support across billing, insurance, claims, collections, and prior authorization processes. While the role covers the full range of billing functions, someone with strong claims experience specifically is ideal. The VA will be responsible for completing assigned billing and authorization tasks accurately and efficiently, maintaining detailed records, communicating with insurance companies and other parties as needed, and helping ensure claims and authorizations are processed in a timely manner. The ideal candidate is highly organized, detail-oriented, comfortable working independently in a remote environment, and willing to learn and adapt as processes and systems evolve.

About the Client

This is a fast-paced, growth-driven pediatric occupational, speech, and physical therapy practice serving multiple locations. Their mission is to enhance the lives of the children they serve and the families who love them by providing a fun, nurturing, and supportive therapeutic environment.

The practice has expanded significantly in recent years and continues to grow, with future goals centered on expanding the team, developing specialty skills, and becoming a leading, sought-after pediatric clinic for both clients and employees.

Key Responsibilities

Insurance & Prior Authorization

• Verify patient insurance eligibility and benefits
• Submit initial and concurrent prior authorizations to Medicaid, Medicaid Managed Care Organizations (MCOs), Medicaid Tailored Health Plans, Tricare, and commercial insurance payers as required
• Monitor authorization timelines and follow up as needed to help prevent gaps in coverage
• Maintain accurate authorization records and client information in the EHR and payer online systems
• Submit additional medical records as requested for claims, appeals, pre-payment reviews, post-payment reviews, or other payer requests

Billing & Claims

• Prepare and submit insurance claims accurately and within required timelines
• Research denied claims, rejected claims, and partial payments, and assist with appropriate follow-up
• Review payer correspondence and EOBs for accuracy and appropriate account processing
• Input and/or download manual insurance checks and accurately apply payments to patient accounts
• Review payment postings to ensure accurate allocation of payments, adjustments, and patient responsibility
• Assist with identifying and resolving billing discrepancies
• Maintain accurate and complete billing documentation in the company EHR and payer online systems

Administrative & General Support

• Follow established billing workflows and payer-specific requirements
• Communicate professionally with insurance companies, patients, physician offices, and internal staff
• Coordinate and follow up with clinical and office staff regarding billing, authorization, and documentation needs
• Accurately document all relevant communication, follow-up, and account activity
• Complete assigned tasks within established timelines
• Assist with other billing, authorization, insurance, and administrative tasks as assigned after appropriate training

Tools & Systems

• Google Workspace
• Microsoft Office
• Company EHR and payer online systems
• Zoom (for training and meetings)