Audiology Biller

Part-Time Remote Medical Biller / Insurance Operations Specialist

Audiology Practice, Philippines-Based Remote Role

Pinnacle Audiology, a growing private audiology practice based in New York City, is seeking a skilled part-time remote medical biller and insurance operations specialist based in the Philippines.

This is not a general virtual assistant position. We are looking for someone with strong experience in U.S. healthcare billing, insurance verification, claims follow-up, appeals, credentialing, and payer enrollment. Experience with audiology, ENT, DME, hearing aids, rehabilitation, therapy, or other insurance-heavy specialties is strongly preferred.

The ideal candidate is detail-oriented, organized, proactive, and comfortable managing the full insurance workflow from benefit verification through payment follow-up.

Responsibilities

Insurance Verification and Benefits

• Verify patient insurance eligibility and benefits.
• Confirm hearing test, hearing aid, tinnitus, and audiology-related coverage.
• Determine deductibles, copays, coinsurance, authorization requirements, exclusions, and remaining benefits.
• Contact commercial insurance plans, Medicare-related plans, third-party hearing aid benefit administrators, and payer portals as needed.
• Prepare clear written benefit summaries for the practice team and patients.
• Identify when hearing aid benefits are carved out through third-party programs such as UHC Hearing, NationsHearing, TruHearing, Hearing Care Solutions, or similar programs.

Claims Submission and Follow-Up

• Submit accurate insurance claims for audiology services and hearing aid-related services.
• Review claims for completeness before submission.
• Track unpaid, rejected, and denied claims.
• Follow up with payers by phone and portal.
• Review EOBs and ERAs.
• Post payments and document patient responsibility.
• Prepare corrected claims when needed.
• Maintain an organized claims aging report.

Appeals and Denials

• Investigate denied or underpaid claims.
• Draft and submit appeals, reconsiderations, corrected claims, and supporting documentation.
• Track appeal deadlines and payer responses.
• Identify patterns in denials and recommend process improvements.
• Communicate clearly with the practice owner and team about claim status and next steps.

Provider Enrollment and Credentialing Support

• Assist with provider enrollment and credentialing applications.
• Help onboard the practice and providers with new insurance companies.
• Track application status, missing documents, CAQH updates, payer requests, effective dates, and contract status.
• Help maintain provider profiles, NPI information, tax ID records, W-9s, licenses, malpractice documents, and payer correspondence.
• Support enrollment with commercial plans, Medicare-related plans, and third-party hearing aid networks when applicable.

Contracting and Rate Negotiation Support

• Assist with reviewing payer contracts and fee schedules.
• Help identify low reimbursement or underpaid codes.
• Contact payer representatives to request fee schedule reviews or improved contracted rates where possible.
• Track contracted rates by payer and code.
• Help organize payer contacts, contract terms, effective dates, and renewal opportunities.

Audiology Billing Focus

Experience with audiology billing is strongly preferred. Relevant codes and workflows may include:

• Comprehensive hearing evaluations
• Tympanometry and acoustic reflex testing
• Hearing aid evaluations
• Hearing aid fittings
• Hearing aid programming
• Hearing aid repairs
• Tinnitus-related services
• Custom ear protection or earmold-related services
• Hearing aid HCPCS codes

Common codes may include:

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• V5261
• Other hearing aid-related HCPCS codes

Ideal Experience

The ideal candidate has experience with some or all of the following:

• U.S. medical billing
• Audiology, ENT, DME, hearing aid, therapy, rehab, or specialty practice billing
• Insurance eligibility and benefits verification
• Commercial insurance plans such as Aetna, UnitedHealthcare, Cigna, Anthem, BCBS, and similar payers
• Medicare and Medicare Advantage basics
• Claims submission and denial management
• EOB and ERA review
• Appeals and corrected claims
• Provider credentialing and payer enrollment
• Contracting or fee schedule review
• Clearinghouses and payer portals

Experience with systems such as Claim.MD, Availity, CAQH, PECOS, Office Ally, Change Healthcare, payer portals, or similar tools is a plus.

Requirements

• Based in the Philippines and able to work remotely.
• Available part-time, approximately 10 to 20 hours per week.
• Must have some overlap with New York business hours.
• Strong written English.
• Excellent attention to detail.
• Reliable internet connection.
• Comfortable working independently.
• Able to provide organized weekly updates.
• HIPAA awareness or willingness to complete HIPAA training.
• Must maintain strict patient confidentiality.

Work Schedule

This is a part-time remote position. Expected hours are approximately 10 to 20 hours per week, with the possibility of increasing over time as the practice grows.

Some overlap with Eastern Time business hours is required for insurance calls, payer follow-up, and team communication.

Compensation

Target compensation is based on experience, with preference for candidates in the $7 to $10 USD per hour range.

Higher compensation may be considered for someone with strong audiology billing, provider enrollment, payer contracting, or revenue cycle experience.

What We Are Looking For

We are looking for someone who can do more than basic data entry. The right candidate should be able to think through insurance problems, follow up persistently, document clearly, and help improve the practice’s billing and insurance systems.

This person should be comfortable saying:

• “Here is what the insurance plan covers.”
• “Here is why the claim denied.”
• “Here is what we need to appeal.”
• “Here is the payer contact and next step.”
• “Here is what needs to be updated for provider enrollment.”
• “Here is where reimbursement appears too low and should be reviewed.”

How to Apply

Please send the following:

1. Your medical billing experience.
2. Any audiology, ENT, DME, hearing aid, therapy, rehab, or specialty billing experience.
3. Payers and insurance portals you have worked with.
4. Billing systems, clearinghouses, or EMRs you have used.
5. Experience with claims, denials, appeals, and AR follow-up.
6. Experience with credentialing, provider enrollment, or payer contracting.
7. Your hourly rate in USD.
8. Your availability in Eastern Time.
9. A brief example of a difficult claim, denial, or insurance issue you helped resolve.

Applicants with direct audiology, ENT, DME, hearing aid, or provider enrollment experience will be prioritized.