Medical Billing Specialist

Medical Billing SpecialistLocation: Colombia Compensation: USD 12,000 – 15,000 per year Openings: 1The client is a U.S.-based ophthalmology and surgical practice specializing in eye care, laser vision correction, and surgical services. The organization operates a fast-paced clinical and surgical environment and places strong emphasis on accuracy, patient experience, and revenue cycle efficiency.Position SummaryThe Medical Billing Specialist is responsible for front-end and back-end revenue cycle support, with a strong focus on insurance eligibility, real-time patient estimates, authorizations, referrals, and medical records management for both clinic and surgical patients. This role also supports patient communication by answering incoming calls and coordinating closely with clinical and billing teams to ensure timely, accurate billing and continuity of care.Key ResponsibilitiesInsurance & EligibilityVerify insurance eligibility and benefits for all clinic and surgical patientsConfirm coverage details, including deductibles, copays, coinsurance, and authorization requirementsIdentify non-covered services and clearly communicate patient financial responsibilityPatient Estimates & Out-of-Pocket (OOP) QuotesGenerate real-time patient estimates for visits, diagnostics, procedures, and surgeriesCalculate expected out-of-pocket costs based on insurance benefits and payer rulesExplain financial responsibility clearly to patients and address related questionsDocument estimates accurately in the EHR / Practice Management systemEscalate complex insurance scenarios or secondary coverage issues as neededAuthorizations & ReferralsObtain and track prior authorizations for in-office procedures, diagnostics, and surgeriesProcess and monitor referrals from PCPs and specialistsEnsure all authorizations and referrals are accurate, active, and properly documentedProactively follow up to prevent delays or claim denialsMedical RecordsRequest, receive, and upload medical records required for authorizations and billingEnsure documentation supports medical necessity and payer requirementsRespond to medical record requests from insurance carriers and external providersBilling SupportPartner with billing and coding teams to support clean claim submissionAssist with resolving eligibility-, authorization-, and estimate-related denialsMaintain accurate patient demographic and insurance dataPatient CommunicationAnswer incoming calls professionally and efficientlyAssist patients with insurance questions, estimates, authorization status, and billing inquiriesRoute clinical or urgent calls appropriatelyAdministrative & ComplianceMaintain HIPAA compliance and adhere to payer guidelinesDocument all insurance and patient financial interactions clearlySupport front desk and clinical teams as needed to maintain patient flowQualificationsMinimum 2+ years of experience in medical billing, eligibility, or revenue cycle managementStrong experience with insurance verification, real-time estimates, authorizations, and referralsSurgical authorization experience preferredProficiency with EHR and Practice Management systemsStrong attention to detail and communication skillsSkills & AttributesHighly organized, efficient, and deadline-drivenComfortable handling high call volume and complex insurance scenariosStrong problem-solving skills and follow-throughPatient-focused with a professional and clear phone presence