Medical Insurance Billing & Verification Specialist - 21012

Medical Insurance Billing & Verification Specialist

• Location: 100% Remote - Open for LATAM Region 
• Salary Range : From $1,200 to $1,600 USD Based on Experience
• Type: Full-time
• Hours: Aligned to U.S. Eastern Time business hours (full daytime overlap required)
• Department: Billing

About the Company

We are an established, U.S.-based healthcare group operating a network of ten chiropractic, rehabilitation, and injury-recovery clinics across South Florida, built over roughly a decade of steady growth. We run a lean, collaborative billing team supported by documented processes, written SOPs, and structured onboarding. Our patient base spans commercial insurance, auto-injury (PIP), workers' compensation, and self-pay, which makes for a varied, high-volume billing environment — the practice processes several thousand claims a month across its locations.

About the Role

This hire is driven by volume and growth. As we scale, we need a billing specialist to independently own insurance verification, authorization, and the full denial and pending-claims follow-up for a defined region of our clinics.

This is its own corner of the business. Ownership of the workflow sits squarely with this person — but they are not on an island. They work inside a collaborative team with support, written resources, and documented processes to lean on. This is not a train-from-scratch role. You should already know how to verify benefits, post payments, and work denials; what we'll teach you is our systems and our nuances (including Florida PIP). We're looking for someone who ramps quickly and takes real ownership from the start.

Key Responsibilities

Insurance Verification & Eligibility

• Verify patient health insurance eligibility and benefits, and serve as backup coverage for the primary verifier when needed
• Confirm deductibles, copayments, coinsurance, and coverage limitations
• Determine in-network and out-of-network benefits
• Document insurance details accurately in the system

Authorization & Referral Management

• Submit authorizations and referrals when required
• Track authorization approvals, denials, and expiration dates
• Coordinate with the treating offices on approved visits and services

Claims Follow-Up & Denial Management (core of the role)

• Own the full denial and pending-claims follow-up workflow for the assigned region of clinics
• Investigate, correct, and resubmit denied and rejected claims through resolution
• Identify recurring denial patterns and flag process issues that affect collections

Payment Posting & Reconciliation Support

• Research and locate insurance payments as requested by the posting team
• Support reconciliation of posted payments against expected reimbursement

Patient & Cash Account Management

• Identify and update patient accounts tied to cash/self-pay programs
• Keep account statuses accurate across insurance and self-pay activity

Required Qualifications

• Prior medical billing experience in a U.S. healthcare setting
• Demonstrated experience following up on and resolving denied and pending claims
• Insurance payment posting experience
• Proven ability to independently own a billing workflow with limited oversight
• Strong written and spoken English
• Reliable full-time overlap with U.S. Eastern business hours

Ideal Candidate Profile

You are:

• Highly organized and detail-driven, and accurate even at high claim volume
• Self-directed — you take ownership and move work forward without being managed task-to-task
• Quick to ramp on new systems and comfortable learning practice-specific nuances
• Steady across a mix of payer types (commercial, PIP, workers' comp, self-pay)
• Collaborative — you use your team as a resource without needing hand-holding
• Dependable and consistent, the kind of person a lean team can trust with a whole region

Why Join Us

You're stepping into a defined, well-supported role — not building the plane while flying it. There are documented SOPs, real onboarding, and a training period to get you fully up to speed, inside an established and growing ten-location group. You'll own a meaningful piece of the business with the support of a collaborative team behind you.