Medical Billing & Insurance Specialist

Winning Assistants LLC

. Manage claims throughout the complete billing cycle .

Posted 10/6/2026full-timeRemote • PhilippinesMid-LevelSenior💰 $10,400 - $12,480 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in full-cycle medical billing and revenue cycle management, with a strong focus on accurate claim preparation, submission, and follow-up. Proficient in navigating insurance portals and ensuring compliance with HIPAA regulations while maintaining detailed billing records.

Highest-signal resume keywords

Medical Billing ExperienceRevenue Cycle Management (RCM)Claim Denial ResolutionInsurance Eligibility VerificationProficiency with Availity

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claim PreparationClaim SubmissionClaim Follow-UpICD-10 CodingCPT CodingClaim ScrubbingBilling DocumentationBilling Guidelines ComplianceInsurance VerificationBilling Issue Identification

Soft Skills

Attention to DetailOrganizational SkillsCommunication SkillsIndependenceCollaboration

Tools & Technologies

AvailityPayer PortalsTriZettoI-Pegasus

Industry Keywords

Medical BillingRevenue CycleInsurance ClaimsHIPAA ComplianceOptometry BillingOphthalmology BillingBlue Cross/Blue ShieldUnitedHealthcareAetnaMedicare

About the role

Key responsibilities & impact

Manage claims throughout the complete billing cycle
Prepare, review, and submit accurate claims
Monitor claim status and follow up on outstanding or unpaid claims
Investigate and resolve rejected and denied claims
Handle appeals and communicate with insurance companies as needed
Identify billing issues that may delay or prevent reimbursement
Maintain accurate billing records and support a healthy revenue cycle
Verify patient eligibility, benefits, and coverage
Work with vision insurance plans, Blue Cross/Blue Shield, UnitedHealthcare, Aetna, Medicare, and Medicaid
Navigate payer portals, particularly Availity
Complete insurance verification with an approximately 10-minute turnaround target
Document coverage, benefits, and relevant insurance information
Review and scrub claims before submission
Confirm diagnosis codes support corresponding CPT/procedure codes
Identify coding-related issues that could lead to claim denials or delayed payments
Support clean and accurate claim submissions
Follow the practice’s coding and billing guidelines
Work closely with the medical scribe and other Virtual Assistants
Maintain accurate and HIPAA-compliant patient and billing documentation
Communicate billing or insurance issues clearly with appropriate team members
Follow established clinic SOPs and billing processes
Participate in training with the clinic team and outgoing medical biller to ensure a smooth transition

Requirements

What you’ll need

Solid hands-on medical billing experience; training or certification alone does not qualify
Experience managing full-cycle medical billing and revenue cycle management (RCM)
Strong experience with medical claim preparation, submission, and follow-up
Hands-on experience resolving claim denials and rejections and handling appeals
Strong insurance eligibility and benefits verification experience
Proficiency with Availity is required
Experience navigating insurance/payer portals
Experience working with commercial and/or government insurance plans such as Blue Cross/Blue Shield, UnitedHealthcare, Aetna, Medicare, and Medicaid
Working knowledge of ICD-10, CPT codes, claim scrubbing, and medical coding principles
Ability to identify billing or coding issues that could result in denials or delayed reimbursement
Strong attention to detail, accuracy, organization, and follow-through
Excellent written and spoken English
Comfortable communicating with insurance companies and internal team members
Ability to work independently while collaborating closely with the clinic team
Ability to learn and follow clinic-specific billing SOPs
Strong understanding of patient confidentiality and HIPAA requirements
Must be able to submit 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, minimum 25 Mbps
Noise-canceling headset
Working webcam for virtual meetings
Quiet and professional work environment
TriZetto experience preferred but not required
i-Pegasus experience is a plus but not required; training will be provided
Optometry or ophthalmology billing experience is a plus but not required
Previous remote or Virtual Assistant experience preferred but not required
Medical or healthcare degree not required
Active medical license not required
Relevant professional medical billing experience is more important than a specific medical degree or license

Benefits

Comp & perks

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
Optional contractor perks and client-approved allowances