Medical Billing & RCM Specialist

• 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
• Maintain accurate patient, billing, insurance, referral, and authorization records
• Use Office Ally, 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
• Follow established SOPs and workflows while maintaining HIPAA compliance

• 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
• 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
• Reliable laptop or desktop computer
• Stable high-speed internet connection of at least 25 Mbps
• Noise-canceling headset
• Working webcam
• Quiet and professional work environment

• Dedicated HR & Contractor Support Team
• Premium VPN Access (Optional)
• HIPAA & Cybersecurity Training + Certification (Provided)
• Top 1% VA Performance Training
• Client-Approved U.S. Holidays
• Client-Approved Paid or Unpaid Time Off
• Access to Tools & Resources
• Optional Performance-Based Incentives
• Independent contractor perks and client-approved allowances