Medical Billing & Claims Specialist

Ensure Revenue Integrity for a Virtual Care Leader

We are a multi-state telehealth provider delivering essential care to patients across the country. As a Medical Billing & Claims Specialist, you will be a crucial part of our financial operations, ensuring the accurate and timely submission of claims for our virtual patient visits. Your expertise will directly support our mission by securing the revenue that allows us to grow and serve more patients.

Core Responsibilities

You will manage the complete claims cycle for our telehealth services, ensuring accuracy and compliance.

• Accurately prepare, review, and submit electronic claims for telehealth services to commercial and government payers (e.g., Medicare, Medicaid).
• Proactively follow up on submitted claims, investigating and resolving any denials, underpayments, or discrepancies with insurance providers.
• Verify patient insurance eligibility and benefits prior to service to ensure proper billing and coverage.
• Collaborate with our Telehealth Provider Schedulers and Practice Manager to clarify billing details and address patient account inquiries.
• Maintain meticulous records of all billing and claims activities, ensuring strict confidentiality of sensitive patient data.
• Stay current with evolving billing codes, payer policies, and regulations specific to telehealth to ensure ongoing compliance.

Qualifications and Experience

We are looking for a detail-oriented professional with experience in the healthcare revenue cycle.

• Minimum of 2 years of experience in medical billing, claims processing, or a similar revenue cycle role. Experience in a telehealth or remote setting is a strong plus.
• Proven track record of submitting clean claims and effectively managing the claim denial resolution process.
• Working knowledge of major insurance payers, including Medicare and Medicaid billing guidelines.
• High proficiency with billing software and electronic health record (EHR) systems. Familiarity with telehealth-specific platforms is advantageous.
• Strong analytical and problem-solving skills for investigating complex billing issues.
• Excellent written and verbal communication skills for professional interactions with insurance companies and internal teams.