CPT-11589 Remittance Payments & Medical Administrative Assistant

Independent Contractor – CPT-11589 Remittance Payments & Medical Administrative Assistant/Business Support VA/Senior Level (Remote).

20four7VA is seeking offshore independent contractors to deliver remote services to clients worldwide, with a primary focus on developed markets such as the United States, the United Kingdom, Canada, and Australia.

The client is seeking an experienced Medical Administrative Assistant to support the clinic’s insurance, billing, administrative, and medical communication operations. The ideal candidate will have experience with medical billing workflows, insurance verification, claims follow-up, remittance processing, payment reconciliation, patient account administration, and professional communication with medical practices and referral partners.
The successful candidate will be highly organized, detail-oriented, and capable of handling sensitive patient, clinical, insurance, and financial information with professionalism, accuracy, confidentiality, and strict compliance with applicable privacy requirements.

The objective of each engagement is to assist the client in improving business efficiency, enhancing service delivery, or supporting operational functions through high-quality, task-specific services rendered by a qualified contractor.

Contractors will be required to provide services that align with the following client tasks:

Insurance Verification and Patient Records

Verify patient insurance coverage before appointments.
Review and update insurance policy information, including member IDs, group numbers, coverage details, and eligibility information.
Confirm copays, deductibles, coinsurance, referral requirements, visit limits, and coverage restrictions when available.
Request updated insurance documentation from patients when necessary.
Maintain accurate and current patient insurance records within the practice management system.
Flag missing, expired, incomplete, or inconsistent insurance information for follow-up.

Claims Review and Correction

Review rejected, denied, incomplete, or unpaid insurance claims.
Identify claim issues, including incorrect patient information, authorization errors, coding discrepancies, missing documentation, or payer processing issues.
Correct and resubmit claims when appropriate.
Document claim corrections, resubmissions, and actions taken.
Maintain claim tracking logs and monitor claim status until resolution.
Escalate complex billing issues to management when required.

Remittance Posting and Payment Processing

Review remittance advice, Explanation of Benefits, and insurer payment summaries.
Accurately post insurance payments and adjustments to patient accounts.
Record patient responsibility amounts, including copays, deductibles, coinsurance, and outstanding balances.
Identify denied claims, underpayments, overpayments, and payment discrepancies.
Ensure timely and accurate remittance posting and account updates.

Payment Reconciliation and Account Review

Reconcile insurance payments against remittance reports and patient accounts.
Review outstanding balances and identify account discrepancies.
Investigate duplicate payments, missing payments, posting errors, or payer discrepancies.
Maintain accurate patient ledgers and account notes.
Support month-end reconciliation activities when required.

Insurance Follow-Up

Contact insurance companies or use payer portals to check claim status.
Follow up on delayed, denied, partially paid, or unresolved claims.
Obtain claim reference numbers and document insurer communications.
Track claim progress and escalate unresolved issues when necessary.
Maintain accurate records of all follow-up activity.
Patient Billing and Administrative Support
Assist with insurance-related patient account inquiries.
Prepare account information for billing follow-up.
Maintain clear, professional, and accurate account notes.
Support administrative documentation, reporting, and record maintenance.
Update internal trackers, spreadsheets, claim logs, and billing reports as required.

Electronic Communications and Medical Practice Liaison Support

Manage electronic communications with medical practices, referring physicians, consultants, insurers, and other approved healthcare stakeholders as required.
Prepare and send documentation relating to new patient initial visits, including appointment confirmations, referral related information, intake documentation, assessment updates, and other approved clinical or administrative correspondence.
Assist with sending progress updates to medical practices or referral sources when requested and approved by the appropriate clinical or management team member.
Support communication regarding patient attendance, appointment status, treatment progress, discharge information, insurance documentation, and other matters deemed necessary by the client.
Ensure all electronic communications are accurate, professional, timely, and appropriately documented within the practice management system or internal tracking systems.
Ensure patient information is only shared with authorized parties and only through approved communication channels.
Escalate any unclear, sensitive, clinical, or complex communication matters to management or the appropriate clinician before sending.

Privacy, Confidentiality, HIPAA, and PIPA Compliance

The contractor must maintain strict confidentiality when handling patient, clinical, insurance, financial, and business information.
The contractor must comply with all applicable privacy, confidentiality, and data protection requirements relevant to the client’s operations.
The contractor must demonstrate awareness of HIPAA principles relating to protected health information, including appropriate access, use, storage, transmission, and disclosure of patient information.
The contractor must also respect and comply with the company's Personal Information Protection Act requirements, recognizing that the client’s place of business and jurisdiction is the company.

The contractor must handle personal information, personal health information, billing records, insurance documentation, and electronic communications in a manner consistent with applicable privacy standards, internal policies, and client instructions.
The contractor must not access, download, store, copy, transmit, disclose, or share patient or business information except as required to complete authorized work duties.
Any suspected privacy breach, unauthorized disclosure, incorrect recipient communication, data handling concern, or confidentiality issue must be reported immediately to the client’s designated point of contact.

Each engagement is based on a defined scope of work and is governed by an independent contractor agreement. Services must be performed professionally, with adherence to any timelines, guidelines, and deliverables agreed upon in writing.

The Contractor must demonstrate proficiency in the following, depending on the Client’s requirements:

• Minimum 2 to 3 years of experience in medical administration, medical billing, insurance verification, or healthcare revenue cycle support.
• Experience working with insurance claims, remittance posting, payment reconciliation, and patient accounts.
• Experience communicating with medical practices, referral sources, insurers, and healthcare administrative teams.
• Strong understanding of insurance terminology, Explanation of Benefits, claim processing, payer workflows, and medical billing procedures.
• Working knowledge of privacy and confidentiality requirements relating to patient information, including HIPAA principles and Bermuda PIPA requirements.
• Excellent attention to detail and accuracy.
• Strong written and verbal English communication skills.
• Ability to maintain confidentiality and handle sensitive patient, clinical, insurance, and financial information appropriately.
• Strong organizational and time management skills.
• Experience working independently in a remote environment.
• Healthcare, physical therapy, or medical practice experience preferred.

Application Software Knowledge and Required Tools

Practice Management Software: Medical billing and practice management systems.
Insurance Portals: Payer and insurance carrier portals.
Documentation: Google Workspace and Microsoft Office.
Communication: Email and secure communication platforms.
Tracking and Reporting: Google Sheets, Excel, internal claim trackers, billing reports, and reconciliation logs.

• Contracted Hours per Week: 30-40 Hours
• Scheduled Working Days: Monday through Friday (unless otherwise mutually agreed in writing)
• Daily Working Time: TBD

Note: The Company will make reasonable efforts to align the Assigned VA’s schedule with the Client’s preferred hours as set forth above. However, availability may vary based on time zones, capacity, and the contracted hours set in this SOW. Any changes must be mutually agreed to in writing through a revised SOW.

• Contractors will operate under a Master Services Agreement and a Statement of Work
• This is not an offer of employment; contractors are not employees of 20four7VA or any client
• All compensation is processed through 20four7VA according to the terms of the engagement

• REQUIRED SERVICE: Business Support
• REQUESTED EXPERIENCE TIER LEVEL: Senior Level
• Contracted Hours per Week: 30-40 hours/week
• Daily Working Time: TBD
• Scheduled Working Days: Monday-Friday
• REPORTING TO/POC: To Be Determined
• Number of VAs: 1
• GENDER PREFERENCE: None
• LANGUAGES SPOKEN/PREFERENCE: English
• ACCENT PREFERENCE: Near Native
• REGION PREFERENCES: Philippines