Medical Billing & RCM Specialist

Job Title: Medical Billing & RCM Specialist
Position Type: Full-Time
Work Hours: 8:00 AM–4:30 PM PDT (30-minute unpaid lunch)
Work Days: Monday–Friday; occasional weekend work may be required as the business grows
Salary: $5–$6/hour, depending on experience
Workplace: Remote
Preferred Candidate Location: Philippines

About the Role

Our client is a growing U.S.-based healthcare diagnostic practice specializing in respiratory, pulmonary, and sleep-related testing. They are looking for an experienced Medical Billing & RCM Specialist who can take ownership of daily billing operations, resolve claim issues, and help maintain a healthy revenue cycle.

The ideal candidate has strong hands-on experience with U.S. medical billing, claims, denials, unpaid claims, insurance verification, and prior authorizations. This role requires someone detail-oriented, organized, proactive, and comfortable working independently across multiple healthcare systems.

Key Responsibilities

• Manage day-to-day medical billing and Revenue Cycle Management (RCM).
• Prepare, submit, and track medical claims through payment.
• Investigate and resolve claim denials, rejections, and unpaid claims.
• Follow up with insurance companies regarding outstanding claims and reimbursement.
• Perform insurance eligibility and benefits verification.
• Process and track prior authorizations and ensure proper documentation.
• Work extensively with Optum, which covers the majority of the practice's patients.
• Maintain accurate patient, billing, insurance, referral, and authorization records.
• Use Office Ally and other systems, including insurance portals, clearinghouses, Square, spreadsheets, and shared drives.
• Maintain clear documentation of billing activities and unresolved issues.
• Communicate professionally with insurance representatives, patients, and healthcare offices as needed.
• Follow established SOPs and workflows while maintaining HIPAA compliance.

Job Title: Medical Billing & RCM SpecialistPosition Type: Full-TimeWork Hours: 8:00 AM–4:30 PM PDT (30-minute unpaid lunch)Work Days: Monday–Friday; occasional weekend work may be required as the business growsSalary: $5–$6/hour, depending on e...

• U.S. healthcare experience is required.
• Medical Billing and RCM experience is required.
• Experience handling claims from submission through payment.
• Experience resolving denials, rejections, and unpaid claims.
• Insurance verification and prior authorization experience is required.
• Experience using healthcare billing, EHR, or practice management systems.
• Office Ally experience is highly preferred.
• Optum experience is a strong advantage.
• Experience with insurance portals and clearinghouses.
• Strong understanding of U.S. medical billing and insurance workflows.
• Previous remote/VA experience is preferred but not required.
• No medical degree or clinical license is required.

Skills & Basic Requirements

• Strong attention to detail, organization, and problem-solving skills.
• Ability to manage multiple claims, follow-ups, and deadlines.
• Strong written and verbal English communication skills.
• Professional phone communication skills.
• Ability to work independently and follow detailed SOPs.
• Knowledge of HIPAA compliance; certification is preferred.
• Must provide an NBI Clearance and/or Local Police Clearance before onboarding.
• Must be available for video meetings with the 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.