Medical Biller

Rheumatology & Dermatology Group | Full-Time | 40 Hours/Week

Central Time Clinic Hours | $7/Hour + 3rd Month Performance Review

The Clinic Need: The clinic has an existing billing team but needs remote billing support due to limited physical office space.
The Role Focus: The Medical Billing Virtual Assistant will support end-to-end billing workflows, including claim creation, claim recreation, billing follow-up, infusion benefits verification, insurance investigation, and related administrative billing tasks.

The Medical Billing Virtual Assistant will support billing operations, including:

Create claims accurately based on patient, visit, provider, and billing information.
Ensure required claim information is complete before submission or review.
Follow internal billing workflows and payer-specific requirements.

Support manual claim creation or claim recreation for the dermatology group when needed.
Work across different systems, including the dermatology EMR and eClinical for billing.
Ensure recreated claims match the required billing documentation.

Verify patient eligibility and benefits coverage for infusion therapy prior to treatment, including confirming authorization requirements and copay/coinsurance amounts.
Research and investigate insurance policies to determine coverage criteria, medical necessity guidelines, and any prior authorization requirements specific to infusion medications and procedures.
Obtain or assist with obtaining prior authorizations from insurance carriers for prescribed infusion therapies, ensuring all documentation is submitted accurately and timely.
Document infusion benefits findings in patient records and communicate coverage limitations, denials, or special requirements to the clinical team and billing manager.
Investigate denied or partially paid infusion claims by reviewing insurance explanations of benefits (EOB), identifying the specific reason for denial, and determining whether an appeal, resubmission, or additional documentation is needed.
Research payer-specific infusion coverage policies, including step therapy, quantity limits, frequency restrictions, and alternative medication requirements.
Track infusion benefit inquiries and follow up with insurance carriers to resolve outstanding coverage questions or documentation requests.

Communicate clearly with the billing team regarding claim issues, missing information, or workflow updates.
Follow instructions from the billing manager and maintain accurate task tracking.
Provide coverage support where needed within the billing department.

At least 1 year of medical billing experience supporting a U.S. healthcare practice.
Certified Medical Biller (CMB) preferred or required based on final client approval.
Must understand the full billing cycle, not just limited claim checking or denial review.
Must be comfortable creating or recreating medical claims manually.
Strong attention to detail when reviewing billing information, patient details, provider data, and claim requirements.
Strong written English communication for billing updates, issue tracking, and internal team coordination.
Must be dependable, consistent, and able to work during Central Time clinic hours.
Must be comfortable learning and working across multiple systems.
Familiarity with insurance benefits verification, prior authorization processes, and insurance claim investigations.
Experience or knowledge of infusion therapy benefits, coverage requirements, and related authorization workflows is strongly preferred.

Prior experience using eClinical for billing workflows is a strong advantage.
Prior rheumatology billing experience is helpful but not required.
Prior dermatology billing experience is helpful, especially for claim creation or claim recreation.
Prior experience with infusion center billing and benefits management.
Experience working between different EMRs, billing systems, or payer portals.
Comfortable supporting a lean team where accuracy, independence, and communication matter.

Originally posted on Himalayas

Medical Biller

Job Description