Role Description This is a remote position. Virtual Rockstar is seeking a full-time Medical Biller for our client’s dynamic and growing healthcare organization specializing in Durable Medical Equipment (DME). This is a fantastic opportunity to work from home while being part of a collaborative and innovative team that strives to provide top-quality service to patients. As a Medical Biller, you will be responsible for processing medical billing and claims for DME, with a strong focus on Medicaid-related workflows, including eligibility verification, claims processing, and authorization. You will work closely with patients, healthcare providers, and insurance companies to ensure timely and accurate reimbursement.

• Review and process DME claims, with a focus on Medicaid claims submission and follow-ups
• Ensure accurate and complete data entry in the Brightree and Noble systems
• Verify insurance coverage and eligibility, with emphasis on Medicaid verification processes
• Manage prior authorizations, particularly for Medicaid cases, including submission and follow-through to approval
• Submit clean claims to insurance companies and follow up on outstanding issues
• Communicate with insurance companies, patients, and providers to resolve billing discrepancies
• Maintain accurate records of claims, payments, and adjustments
• Stay up to date with insurance policies, billing codes, and regulatory requirements, especially Medicaid guidelines
• Resolve denials and rejections promptly and efficiently, including Medicaid-related denials

Qualifications

• Experience in billing for durable medical equipment (DME), with a strong focus on Medicaid claims, eligibility verification, and authorization processes.
• Proficiency in using Brightree and Noble billing software.
• Strong understanding of insurance policies, coding (HCPCS, ICD-10, etc.), and DME billing procedures.
• In-depth knowledge of Medicaid workflows, including claims submission, follow-ups, and reimbursement processes.
• Excellent attention to detail and organizational skills.
• Strong communication skills, both written and verbal.
• Ability to work independently and efficiently in a remote work environment.
• Knowledge of Medicare and private insurance reimbursement processes is a plus.

Benefits

• Competitive salary commensurate with experience.
• Opportunities for professional development and growth.
• Work in a dynamic and supportive team environment.
• Make a meaningful impact by helping to build and strengthen families in the Philippines.