Virtual Medical Biller – Billing Support Specialist

• Verify patient insurance coverage and determine prior authorization requirements
• Compile clinical documentation, submit authorization requests, and follow up through final approval
• Manage authorization numbers and validity dates in eClinicalWorks before patient encounters
• Work A/R aging reports and contact commercial and government payors regarding unpaid, underpaid, denied, or stalled claims
• Post insurance ERAs/EOBs and patient payments, including line-item payments, contractual adjustments, and deductibles
• Scrub and submit primary and secondary claims
• Audit clearinghouse and payor rejections and make coding or demographic corrections for clean-claim resubmissions
• Draft denial appeals and corrected claims
• Resolve outstanding balances and maintain clean billing records in eClinicalWorks
• Maintain HIPAA compliance and protect patient financial records

• 3+ years of direct U.S. medical billing experience spanning verification, prior auths, A/R, posting, and claims
• Mastery of CPT, ICD-10, HCPCS codes, modifier applications, and medical terminology
• Strong proficiency in reviewing EOBs/ERAs, working denials, and navigating commercial payor portals
• Exceptional attention to detail, proactive follow-through, and ability to work independently with minimal supervision
• Excellent written/spoken English and comprehensive knowledge of HIPAA regulations
• Private, HIPAA-compliant office setup with a high-performance computer, primary high-speed internet, backup power/internet, and a headset
• Recent hands-on experience in eClinicalWorks (eCW) billing, eligibility, authorizations, posting, and A/R modules strongly preferred
• Direct orthopedic medical billing and surgical/diagnostic authorization experience strongly preferred