Medical Insurance Billing & Verification Specialist - 21012

• Location:  100% Remote  - Open for LATAM  Region 
• Salary Range: From $1,000 to $1,500  USD Based on Experience
• Type: Full-time
• Hours: Aligned to U.S. Eastern Time business hours (full daytime overlap required)
• Department: Billing

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.

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.

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

• 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

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