Han Orthopaedics is seeking an experienced, autonomous Virtual Medical Biller / Billing Support Specialist to join our dedicated billing team. In this role, you will take ownership of key revenue cycle management (RCM) functions, including insurance eligibility verification, prior authorizations, accounts receivable (A/R) follow-up, payment posting, and claims management within eClinicalWorks (eCW).
The ideal candidate possesses deep expertise in U.S. orthopedic medical billing, CPT/ICD-10 coding, and EOB/ERA analysis, with a persistent follow-through mindset to resolve unpaid claims and secure authorizations efficiently.
Working Environment & Core Schedule
- Role Title: Virtual Medical Biller / Billing Support Specialist
- Practice: Han Orthopaedics
- Status: Full-Time (40 Hours / Week)
- Schedule: Monday – Friday, 8:00 AM – 5:00 PM PST (Pacific Standard Time)
- Core EHR/Billing Platform: eClinicalWorks (eCW) (Strongly Preferred)
- Specialty Focus: Orthopedics & Musculoskeletal Care
Top 3 Daily Tasks
- Insurance Verification & Prior Authorizations: Verify patient coverage, determine prior auth rules, compile clinical documentation, submit requests, and follow up relentlessly through final approval.
- Accounts Receivable (A/R) & Payment Posting: Work aging reports, investigate unpaid/underpaid claims with payors, post insurance ERAs/EOBs and patient payments, and resolve balances.
- Claims & Medical Billing Support: Scrub and submit primary/secondary claims, clear billing rejections, draft denial appeals/corrected claims, and maintain clean billing records in eCW.
Core Responsibilities
- Manage the end-to-end authorization process, ensuring authorization numbers and validity dates are meticulously documented in eCW before patient encounters.
- Audit clearinghouse and payor claim rejections, making timely coding or demographic corrections to ensure rapid clean-claim resubmissions.
- Work A/R aging work queues systematically, contacting commercial and government payors to overturn denied or stalled claims.
- Accurately post line-item payments, contractual adjustments, and deductibles from EOBs/ERAs.
- Maintain complete HIPAA compliance and protect patient financial records across all workflows.
Requirements
- U.S. Billing Experience: 3+ years of direct U.S. medical billing experience spanning verification, prior auths, A/R, posting, and claims.
- Coding & Terminology Knowledge: Mastery of CPT, ICD-10, HCPCS codes, modifier applications, and medical terminology.
- RCM Competency: Strong proficiency in reviewing EOBs/ERAs, working denials, and navigating commercial payor portals.
- Autonomous Execution: Exceptional attention to detail, proactive follow-through, and the ability to work independently with minimal supervision.
- Communication & HIPAA: Excellent written/spoken English and comprehensive knowledge of HIPAA regulations.
- Remote Workspace: Private, HIPAA-compliant office setup with a high-performance computer, primary high-speed internet, backup power/internet, and a headset.
Strongly Preferred Qualifications
- EHR Mastery: Recent hands-on experience in eClinicalWorks (eCW) billing, eligibility, auths, posting, and A/R modules.
- Specialty Background: Direct orthopedic medical billing and surgical/diagnostic authorization experience.
Ideal Candidate Profile
You are a seasoned revenue cycle specialist who understands the nuances of orthopedic billing. You hit the ground running in eClinicalWorks, handle payor authorizations with precision, and never leave money on the table when working A/R.
