远程医疗虚拟计费员（RCM, 许可证及验证专员）
Remote Medical Virtual Biller (RCM, Authorizations & Verification Specialist)
We are seeking an experienced, detail-oriented Medical Virtual Biller to join our remote operations team. In this role, you will be responsible for managing end-to-end Revenue Cycle Management (RCM) tasks, with a heavy emphasis on patient benefit verification, tracking maximum benefits, and coordinating complex payer documentation.
If you have a strong background in U.S. healthcare billing, possess deep familiarity with insurance verification protocols, and excel at securing prior authorizations and clinical letters, we want to hear from you!
Requirements
· Benefit Verification & Eligibility: Accurately verify patient insurance coverage, active policy status, copays, deductibles, coinsurance, and maximum benefit limits prior to service delivery.
· Prior Authorizations & LOAs: Proactively initiate, track, and follow up on Letters of Authorization (LOAs) and pre-authorizations with insurance payers to ensure timely approvals and prevent claim denials.
· Payer Correspondence & LOIs: Draft, compile, and submit Letters of Intent / Medical Necessity (LOIs) alongside clinical documentation to support appeals, gap-in-network exceptions, or specialized treatments.
· Full-Cycle RCM Support: Handle tasks across the billing lifecycle, including charge entry, claim submission, payment posting, and handling accounts receivable (A/R) follow-ups or denials.
· Documentation & Compliance: Maintain meticulous records of payer interactions, authorization numbers, and patient financial clearances within our Electronic Health Record (EHR) / Practice Management systems while maintaining strict HIPAA compliance.
Qualifications & Requirements
· Experience: Minimum of 2–3+ years of hands-on experience in U.S. Medical Billing, Medical Virtual Assisting, or RCM roles.
· Core Knowledge: Proven expertise in handling insurance verification, calculating/tracking maximum benefits, and securing LOAs and LOIs.
· Technical Proficiency: Familiarity with major U.S. EHR/PM platforms (e.g., Epic, Athenahealth, eClinicalWorks, Kareo, or similar systems) and clearinghouse portals.
· Communication Skills: Excellent written and spoken English, with the confidence to communicate professionally with U.S.-based insurance providers, patients, and internal team members.
· Home Setup: A reliable high-speed internet connection (minimum 25+ Mbps) and a quiet, secure, HIPAA-compliant home office workspace.
Originally posted on Himalayas