Medical Biller (Infusion & Rheumatology) - 64434941719

MEDICAL BILLER - Infusion & Rheumatology

Compensation: $1,200 to $1,800 USD/month, commensurate with experience
Location: Remote, Latin America or the Philippines
Schedule: Monday to Friday, 8:00 AM to 4:30 PM CST, with a 30-minute break
Reports To: Chief Operating Officer
Employment Type: Full-time, Independent Contractor

About the Company

Our client is a growing specialty medical practice focused on rheumatology, infusion therapy, and regenerative medicine. As the practice continues to grow, we are strengthening our billing and reimbursement operations to improve collections, reduce denials, and maintain accurate financial visibility across increasingly complex specialty and infusion workflows.

Role Overview

This is an urgent hiring need. We are specifically looking for an experienced Medical Biller with strong eClinicalWorks experience and direct hands-on experience in infusion or specialty medical billing .

The ideal candidate will have proven expertise across reimbursement tracking, reporting, payment posting, accounts receivable, and denial management , with the ability to independently identify, investigate, and resolve billing and reimbursement issues.

This is not an entry-level role . The successful candidate will own core billing workflows, maintain accurate reporting, proactively address denials and payment discrepancies, and strengthen billing operations as the practice continues to scale.

Key Responsibilities

Claims Submission & Denial Management

• Submit and manage claims for infusion, rheumatology, and regenerative services.
• Work across eClinicalWorks Practice Management, Waystar, Inbox Health, and direct-entry payer platforms.
• Review and accurately interpret EOBs and ERAs.
• Proactively follow up on unpaid, partially paid, underpaid, and denied claims.
• Investigate denial root causes and resolve issues related to coding, modifiers, authorization, and place of service.
• Prepare and submit appeals with appropriate supporting documentation.
• Maintain low avoidable denial rates and ensure claims over 30 days receive timely, documented follow-up.

Payment Posting & Reconciliation

• Accurately post EFT payments and paper checks without backlog.
• Reconcile deposits against clearinghouse reports, bank activity, EOBs, and internal payment records.
• Apply contractual adjustments accurately based on payer fee schedules.
• Identify and resolve discrepancies between EOBs, claims, ledgers, and distributor invoices.
• Track outstanding reimbursement variances through resolution.

Infusion & Biologics Billing

• Manage biologics billing workflows, including J codes, wastage documentation, modifier usage, authorization alignment, and place-of-service requirements.
• Maintain and expand infusion reimbursement tracking, comparing expected reimbursement against actual payments.
• Investigate missing, delayed, partial, and underpaid infusion reimbursements.
• Track copay assistance programs and manufacturer payments.
• Audit GPO and distributor invoices for pricing and quantity accuracy.

Reporting & Reimbursement Oversight

• Maintain recurring reports covering AR, denials, reimbursements, collections, payment posting, and unresolved payer issues.
• Provide leadership with concise reporting on trends, discrepancies, risk areas, and recommended actions.
• Maintain detailed reimbursement issue logs and supporting documentation.
• Identify patterns in denials, underpayments, and reimbursement discrepancies and proactively escalate concerns.
• Support ProKure-related billing, payment, reimbursement, and reporting workflows as implementation expands.
• Document workflows and build appropriate controls in preparation for assuming additional MID-related responsibilities.
• Respond promptly to patient and internal billing inquiries.
• Refer eligible accounts to collections every 90 days in accordance with company policy.

Hard Skills & Requirements

• 3+ years of hands-on medical billing experience in infusion, rheumatology, oncology, biologics, or another specialty medical environment.
• Strong eClinicalWorks billing experience is required.
• Direct experience with infusion or specialty medical billing is required.
• Strong experience with Waystar, Inbox Health, and payer portals preferred.
• Demonstrated ability to independently interpret EOBs and ERAs .
• Experience posting EFT payments and paper checks .
• Strong understanding of CPT, HCPCS, J codes, Modifier 25, Modifier JW, and place-of-service requirements .
• Proven experience with AR aging, denial management, reimbursement discrepancies, and appeals .
• Experience creating and maintaining reimbursement reports and tracking spreadsheets .
• Strong Excel/spreadsheet skills.
• Ability to work across multiple systems simultaneously.
• Working knowledge of HIPAA requirements and secure handling of patient information.

Soft Skills

• Highly detail-oriented and accurate.
• Strong analytical and problem-solving skills.
• Proactive in identifying and resolving discrepancies.
• Highly organized with excellent follow-through.
• Comfortable working independently with limited supervision.
• Reliable and consistently responsive during scheduled hours.
• Clear and professional written and verbal communication.
• Strong ownership, accountability, and judgment.
• High level of professional integrity and discretion.

About the Ideal Candidate

The ideal candidate is an experienced medical billing professional who understands that successful billing goes beyond simply submitting claims.

You are comfortable reviewing an EOB, identifying why a claim was denied or underpaid, tracing the issue across multiple systems, documenting the variance, and following it through to resolution. You can independently manage AR and reimbursement workflows while maintaining accurate reporting for leadership.

You are also highly dependable in a remote environment and can manage competing priorities without requiring continuous oversight.

Remote Work Requirements

• Dedicated, professional remote workspace.
• Two functioning monitors to support multi-system billing workflows.
• High-speed, reliable internet connection.
• Ability to securely manage two-factor authentication and multiple billing platforms.
• Ability to work consistently during the required CST schedule .
• Commitment to HIPAA-compliant handling of patient and billing information.

Why This Role Matters

This role directly impacts the practice's cash flow, reimbursement performance, and ability to scale.

The Medical Biller will help ensure claims are submitted accurately, payments are posted correctly, denials are resolved quickly, and infusion reimbursement is tracked from expected payment through collection. The person in this role will also help establish stronger reporting and billing controls as the practice expands.

Performance Expectations

Success in this role will be measured by:

• Accurate first-pass claims submission and minimal avoidable denials.
• Consistent payment posting and reconciliation without backlog.
• Timely, documented follow-up on aging claims and reimbursement variances.
• Accurate and current infusion reimbursement tracking.
• Reliable recurring billing, AR, and reimbursement reporting.
• Proactive identification and resolution of billing discrepancies.
• Well-documented workflows supporting expanded ProKure and MID responsibilities.
• Consistent responsiveness and reliability throughout scheduled working hours.

Hiring Process

• Preliminary interview to assess communication skills and relevant billing experience.
• Technical interview covering real-world billing scenarios, EOB/ERA interpretation, denial management, and reimbursement workflows.
• Final interview with the Owner.