For this role, our client is in pursuit of an experienced Medicaid Virtual Assistant who will be responsible for handling medical billing, ensuring claims are processed in accordance with payer regulations, and guaranteeing requested authorizations are successfully renewed. This is a full-time position during Eastern Standard Time from 9AM - 5PM.

The following Job-related experience is required for potential candidates for this role:

Must have at least a year of experience in the healthcare and customer service industries as a Medical Billing Specialist, Collections Specialist, Benefits Specialist, or similar role.
Must have proficiency in various CRM systems and strong analytical thinking skills.
Must have working experience in data entry and the ability to quickly learn and adapt to new systems.
Must have strong time management, follow-up, and communication skills, with proficiency in Microsoft Office Suite (Outlook, Word, Excel).
Must be familiar with healthcare billing, collections, third-party payers (such as VA, Medicaid, Medicare Advantage, Worker’s Compensation), and industry-standard forms (UB04, HCFA 1500).
Must be knowledgeable of claims procedures, including working with denials, partial payments, and claims discrepancies.
Preferably with experience with PowerBI and healthcare collections techniques.
Medical/healthcare billing experience, especially working with insurance and third-party payers is a huge advantage.
Familiarity with healthcare authorization processes, including Medicaid and VA authorizations is preferred.
Understanding of healthcare-related codes, protocols, and documentation requirements is desired.

Your responsibilities will include but are not limited to the following:

Manage and monitor customer accounts, ensuring timely resolution of overdue payments by identifying and correcting errors in submitted claims.
Effectively communicate with team members, third-party payers, and customers via phone and email to resolve claims issues, providing timely follow-up to ensure payments are received.
Analyze and research trends in claims rejections and partial payments using tools like PowerBI, and develop action plans to address discrepancies.
Ensure claims are processed accurately, following payer regulations, protocols, medical authorizations, and department guidelines.
Review and input authorization and billing data into various systems, such as the client's billing management tool, ensuring seamless and accurate processing.
Collaborate with customers and internal teams to ensure the renewal of at least 90% of requested authorizations, addressing any missing claims or data from reports.
Research and understand the authorization renewal process for VA Medical Centers, Medicaid, and other third-party payers, improving internal procedures.
Conduct weekly virtual meetings with clients to facilitate the onboarding process for authorization management services.
Demonstrate excellent organizational and time-management skills, ensuring the prioritization of activities such as resolving denials, partial payments, and authorization renewals within required timelines.
Maintain thorough and accurate records of all communications, actions, and resolutions in the CRM, ensuring data integrity and compliance.
Provide exceptional customer service by addressing client inquiries, troubleshooting issues, and offering proactive solutions to ensure customer satisfaction.

Successful candidates for this role are expected to possess the following attributes:

Must have excellent English communication skills.
Has the ability to complete projects in a timely manner.
Great logical and verbal reasoning skills.
Exceptionally detail-oriented.
Exceptional problem-solving and information-processing skills.
Ability to think outside the box.
A great work ethic and interest in learning new concepts and growing with the job.
Ability to work both independently and as part of a team.
Must have their own work device (preferably a desktop or laptop) and a stable internet connection.

Successful candidates for this role will be rewarded with the following benefits and compensation:

A total of five paid vacation days per year (additional days can be taken unpaid).
A 5% raise per year guaranteed (additional raises or bonuses may be given for outstanding performance).
A paid 15-minute break for every 4 hours of work.
Fully-paid healthcare benefits after 2 months of full-time work.
Compensation range: $4.00 - $7.00 per hour.