Submit accurate insurance claims via SimplePractice, verifying CPT codes, diagnosis codes, payer IDs, and fees prior to submission; monitor claim status on a bi-monthly cadence and process resubmissions, reconsiderations, and appeals as needed.
Generate and send invoices for deductibles, coinsurance, no-show fees, and private pay balances; follow up with patients on outstanding amounts and manage accounts escalated to collections per company policy.
Verify patient benefits including deductibles, coinsurance, and visit limits prior to billing; identify and communicate insurance red flags, ensure required agreements are signed, and track deductible accumulation.
Review EOBs to confirm payment accuracy, match payments to dates of service, and identify discrepancies; reconcile insurance payments against internal records and investigate mismatches or missing payments.
Identify cases where insurance payments are sent directly to patients and initiate follow-up via portal, SMS, or email to collect and apply outstanding payments; escalate unresolved cases as needed.
Maintain Admin Notes in SimplePractice, Trello tracking cards, and internal spreadsheets for audit readiness; manage pre-authorizations, pre-certifications, and auto accident workflows; communicate clearly with patients on coverage, billing responsibilities, and payment expectations.

Minimum 2.5-5 years of hands-on medical billing experience in an insurance-based setting, with a demonstrated track record of managing full revenue cycle workflows independently.
Solid understanding of CPT and ICD coding, CMS-1500 claim submission processes, and payer-specific billing rules across multiple insurance carriers.
Direct experience with SimplePractice or a comparable EHR platform; comfort working across insurance portals including Availity, UHC, Cigna, and similar carrier systems.
Strong working knowledge of deductibles, coinsurance, EOBs, appeals, pre-authorizations, and out-of-network (OON) billing workflows.
Highly detail-oriented with strong documentation habits, ability to manage multiple active accounts simultaneously, and consistent follow-up on all outstanding claims and patient balances.
Experience in acupuncture, physical therapy, or a similar specialty healthcare setting preferred; proficiency with Google Sheets, LastPass, and Trello required; familiarity with Zoho One for patient communications is an added bonus.

Competitive salary
Opportunity to shape the HR function of a rapidly growing BPO.
Work closely with a team of industry leaders who have successfully scaled BPOs in the past.
Career growth and development opportunities.

Medical Billing

Key skills