Remote Medical Billing & RCM Specialist: US Claims Pro

Winning Assistants, Inc.; Philippines; Remote; PHP 433,000 - 519,000; Full time

Benefits offered by this job

HIPAA training

VPN access

Cybersecurity training

Client support

Job summary

Winning Assistants, Inc. is seeking a Medical Billing & RCM Specialist to own daily billing operations for a U.S.-based diagnostic practice. The role emphasizes claims submission, denial management, and payer follow-up while maintaining HIPAA-compliant processes.

Remote work is supported with a preference for candidates in the Philippines. The ideal candidate has hands-on experience with U.S. medical billing, claims, denials, insurance verification, and prior authorizations, and can work

Qualifications

• U.S. healthcare billing experience is required.
• Experience managing claims from submission to payment is essential.
• Strong knowledge of denials, rejections, and unpaid claims is needed.
• Experience with insurance verification and prior authorizations is required.
• Familiarity with HIPAA compliance and privacy rules is preferred.

Responsibilities

• Manage day-to-day medical billing and Revenue Cycle Management (RCM).
• Prepare, submit, and track medical claims through payment.
• Investigate and resolve claim denials and unpaid claims.
• Follow up with insurance companies on outstanding claims and reimbursements.
• Perform insurance eligibility verification and benefits verification.
• Process and track prior authorizations and ensure proper documentation.
• Work with Optum and other systems like Office Ally, portals, clearinghouses, and spreadsheets.
• Maintain accurate patient, billing, insurance, referral, and authorization records.
• Communicate professionally with insurance representatives, patients, and healthcare offices.

Skills

US healthcare experience

Medical Billing

RCM

Claims processing

Denials management

Insurance verification

Prior authorizations

Office Ally

Optum

EHR/Practice Management

Clearinghouses

HIPAA compliance

Tools

Office Ally

Optum

Job description

Winning Assistants, Inc. is seeking a Medical Billing & RCM Specialist to own daily billing operations for a U.S.-based diagnostic practice. The role emphasizes claims submission, denial management, and payer follow-up while maintaining HIPAA-compliant processes.

Remote work is supported with a preference for candidates in the Philippines. The ideal candidate has hands-on experience with U.S. medical billing, claims, denials, insurance verification, and prior authorizations, and can work