Medical Billing & Prior Authorization Specialist
W
Winning AssistantsBehavioral health
Preferred Candidate Location: Philippines, US Central Time business hours: 9:00 AM–6:00 PM Central Time, Monday–Friday; occasional weekend follow-ups around 1:00 PM Central Time.Contract
Salary5 - 7 USD per hour
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Job Details
- Languages
- Must be proficient in speaking and writing English clearly and professionally.
- Required Skills
- HIPAA
Requirements
- Have previous hands-on experience with US healthcare insurance billing and claims processing.
- Have experience with insurance claim submissions, billing follow-ups, and resolving claim discrepancies.
- Know prior authorization workflows, insurance eligibility, and benefits verification.
- Be familiar with US healthcare billing procedures, payer requirements, and insurance terminology.
- Speak and write English clearly and professionally.
- Follow HIPAA guidelines and maintain patient information confidentiality.
- Be available to work US Central Time business hours and accommodate occasional weekend follow-ups.
- Submit an NBI Clearance and/or Local Police Clearance before onboarding.
- Be able to work independently, manage multiple tasks and deadlines, and communicate with US patients, insurers, and healthcare professionals.
- Have a reliable computer, stable high-speed internet of at least 25 Mbps, a noise-canceling headset, webcam, and quiet professional workspace.
- Psychology, psychiatry, or behavioral health billing experience is highly preferred.
- Experience with TherapyNotes, Tebra, RingCentral, or similar healthcare systems is an advantage.
Responsibilities
- Process approximately 20–30 US healthcare insurance claims daily and submit them accurately and on time.
- Review billing information, insurance coverage, provider details, and documentation before submitting claims.
- Identify and resolve billing discrepancies, rejected claims, and processing issues.
- Handle prior authorization requests for applicable behavioral health and psychiatric services.
- Verify insurance requirements, coverage limitations, and authorization status.
- Coordinate with providers, insurance companies, and internal staff to obtain required documentation.
- Track pending authorizations and follow up on outstanding requests, approvals, denials, and expiration dates.
- Follow up on unpaid, pending, rejected, or denied claims and clarify claim statuses and payment discrepancies with insurers.
- Maintain organized billing records and document billing procedures and administrative workflows.
- Communicate with patients, clinics, insurance representatives, and the clinical team; handle calls using RingCentral.
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