Remote Medical Virtual Biller (RCM, Authorizations & Verification Specialist)

Requirements

* Benefit Verification & Eligibility: Accurately verify patient insurance coverage, active policy status, copays, deductibles, coinsurance, and maximum benefit limits prior to service delivery.

* Prior Authorizations & LOAs: Proactively initiate, track, and follow up on Letters of Authorization (LOAs) and pre-authorizations with insurance payers to ensure timely approvals and prevent claim denials.

* Payer Correspondence & LOIs: Draft, compile, and submit Letters of Intent / Medical Necessity (LOIs) alongside clinical documentation to support appeals, gap-in-network exceptions, or specialized treatments.

* Full-Cycle RCM Support: Handle tasks across the billing lifecycle, including charge entry, claim submission, payment posting, and handling accounts receivable (A/R) follow-ups or denials.

* Documentation & Compliance: Maintain meticulous records of payer interactions, authorization numbers, and patient financial clearances within our Electronic Health Record (EHR) / Practice Management systems while maintaining strict HIPAA compliance.

Qualifications & Requirements

* Experience: Minimum of 2–3+ years of hands-on experience in U.S. Medical Billing, Medical Virtual Assisting, or RCM roles.

* Core Knowledge: Proven expertise in handling insurance verification, calculating/tracking maximum benefits, and securing LOAs and LOIs.

* Technical Proficiency: Familiarity with major U.S. EHR/PM platforms (e.g., Epic, Athenahealth, eClinicalWorks, Kareo, or similar systems) and clearinghouse portals.

* Communication Skills: Excellent written and spoken English, with the confidence to communicate professionally with U.S.-based insurance providers, patients, and internal team members.

* Home Setup: A reliable high-speed internet connection (minimum 25+ Mbps) and a quiet, secure, HIPAA-compliant home office workspace.