Medical Biller – Pediatric Practice Virtual Assistant

Medical Biller – Pediatric Practice

About the role

Perform the day-to-day billing work that supports timely, accurate reimbursement, including claim submission, denial follow-up, payment posting, and patient billing support. Escalate complex denials and coding questions to the Lead Biller.

Key responsibilities

• Review charges for accuracy and completeness before submitting claims
• Submit clean claims promptly and within payer filing deadlines
• Follow up on rejected, denied, unpaid, and aged claims
• Contact insurers to resolve claim issues and track each issue through resolution
• Gather supporting documentation and escalate complex denials or coding questions to the Lead Biller
• Accurately post payments, approved adjustments, and patient responsibility amounts
• Send receipts and issue statements according to practice procedures
• Respond to patient billing questions clearly and empathetically
• Follow up on outstanding balances and communicate approved payment-plan options

About you

• Medical billing experience, including denial and rejection follow-up
• Experience with charge entry, claim review, payment posting, and clearinghouse workflows
• Working knowledge of ICD-10-CM, CPT, and HCPCS coding
• Proficiency with practice management systems
• Confidence communicating with insurers and patients by phone and message
• Strong attention to detail, organization, and follow-through
• Commitment to patient privacy, confidentiality, and data security
• Preferred: Pediatric billing experience
• Preferred: Familiarity with Hawaii payers, including HMSA, and fee-for-service billing
• Preferred: Experience working remotely and coordinating with a distributed team