Medical Biller & Collections Specialist - Freelance, Remote
Magic One
Medical Biller & Collections Specialist - Freelance, Remote
Description\nAbout the Client
A nationally focused clinical specialty pharmacy that provides home infusion, specialty and compounding services with a strong emphasis on personalized, community-based care. The organization is accredited and operates with rigorous compliance and HIPAA standards while serving multiple states. They prioritize timely authorizations, clinical support, and high-quality billing/reimbursement practices to ensure patients receive home-based infusion therapies.\n
Why does this role exist?
This role exists to accelerate and stabilize revenue collection for home infusion services by managing insurance-side billing and out-of-network claim recoveries. The specialist will reduce accounts receivable backlog, resolve denials and underpayments, and negotiate reimbursements with payers so clinical teams can focus on patient care. Hiring this specialist ensures compliant, efficient collections and improved cash flow for infusion services.
The Impact you’ll makeAccounts Receivable Management\nMonitor and manage patient and insurance accounts to ensure timely collection of outstanding balances.\nReview unpaid or partially paid claims, verify billing details, and follow up with payers to secure payment.\nMaintain accurate aging trackers and prioritize high-risk accounts.\nBilling and Documentation\nReview claims for completeness and payer compliance before resubmission.\nEnsure accurate posting of payments, adjustments, and account notes in billing systems.\nMaintain detailed records of collection activities, insurance communications, and follow-ups.\nOut-of-Network Claims Management\nVerify coverage and eligibility for out-of-network claims, obtain necessary authorizations, and prepare documentation for reimbursement requests.\nNegotiate payment terms and reimbursements with insurance companies for out-of-network services.\nManage balance-billing workflows and coordinate with internal teams to determine patient responsibility (note: role focuses on insurance-side collections; no direct patient outreach).\nDispute Resolution & Denial Management\nInvestigate claim denials or underpayments, obtain supporting clinical/billing documentation, and submit appeals or corrections as required.\nCollaborate with pharmacy staff and payer representatives to resolve disputes and implement corrective actions.\nTrack denial reasons and recommend process improvements to reduce recurrence.\nReporting & Compliance\nPrepare regular AR, aging, and collections activity reports for management review.\nAnalyze trends (denials, payer behavior, aging) and suggest optimizations to collection processes.\nEnsure all activities comply with HIPAA, payer policies, and internal billing best practices.\n
Skills, Knowledge and ExpertiseRequired:\nProven experience in medical billing and collections with direct experience managing out-of-network claims (home infusion pharmacy experience preferred).\nStrong knowledge of CPT and ICD-10 coding and payer requirements for infusion services.\nProficiency with Caretend and CPR Plus (or equivalent billing systems) and strong Excel skills.\nDemonstrated experience negotiating with insurance companies and resolving denials/underpayments.\nAbility to work Monday–Friday, 9:00 AM–5:00 PM PST (40 hours/week) and maintain a HIPAA-compliant remote workspace.\nWFH Set-Up:\nComputer with at least 8GB RAM, an Intel i5 core processor/AMD Ryzen 5 Processor and up.\nInternet speed of at least 40MBPS\nHeadset with an extended mic that has noise cancellation and a webcam\nBack-up computer and internet connection\nQuiet, dedicated workspace at home\n\n\nYour Superpowers:\nDeep knowledge of medical billing workflows, claims submission, appeals, and payer negotiations.\nProficient with Caretend, CPR Plus, MS Excel, Word, and Google Workspace.\nFamiliarity with coding (CPT, ICD-10) and payer-specific documentation requirements. Soft skills\nExcellent negotiation and written communication skills focused on insurer interactions.\nHigh attention to detail, organization, and ability to manage competing priorities.\nProblem-solver mindset and persistence in follow-up to drive collections.\nIntegrity and strict adherence to HIPAA and privacy regulations.\nYou should apply if...\nYou enjoy investigative work and are motivated by resolving denials and recovering revenue.\nYou are self-directed, reliable on a consistent PST schedule, and comfortable working remotely.\nYou value compliance, clear documentation, and collaborative problem solving with clinical and operational teams.\nYou’re patient, persistent, and able to negotiate professionally with payers without escalating to clinical teams unnecessarily.\n\nWhat to expect...
\nWork Setup:\nRemote position\nMust have a reliable internet connection and a quiet workspace\nRequired to provide own computer with Intel Core i5 or something similar or higher operating system\nWorking Hours:\n40 hours per week\nMonday–Friday, 9:00 AM–5:00 PM Pacific Time\nCompensation:\n$9 per hour\nNo benefits package included\n
Benefits
Department: Support & Leadership
Employment Type: Full Time
Location: Philippines
Reporting To: Client via Magic
Compensation: $9.00 / hour
Description\nAbout the Client
A nationally focused clinical specialty pharmacy that provides home infusion, specialty and compounding services with a strong emphasis on personalized, community-based care. The organization is accredited and operates with rigorous compliance and HIPAA standards while serving multiple states. They prioritize timely authorizations, clinical support, and high-quality billing/reimbursement practices to ensure patients receive home-based infusion therapies.\n
Why does this role exist?
This role exists to accelerate and stabilize revenue collection for home infusion services by managing insurance-side billing and out-of-network claim recoveries. The specialist will reduce accounts receivable backlog, resolve denials and underpayments, and negotiate reimbursements with payers so clinical teams can focus on patient care. Hiring this specialist ensures compliant, efficient collections and improved cash flow for infusion services.
The Impact you’ll makeAccounts Receivable Management\nMonitor and manage patient and insurance accounts to ensure timely collection of outstanding balances.\nReview unpaid or partially paid claims, verify billing details, and follow up with payers to secure payment.\nMaintain accurate aging trackers and prioritize high-risk accounts.\nBilling and Documentation\nReview claims for completeness and payer compliance before resubmission.\nEnsure accurate posting of payments, adjustments, and account notes in billing systems.\nMaintain detailed records of collection activities, insurance communications, and follow-ups.\nOut-of-Network Claims Management\nVerify coverage and eligibility for out-of-network claims, obtain necessary authorizations, and prepare documentation for reimbursement requests.\nNegotiate payment terms and reimbursements with insurance companies for out-of-network services.\nManage balance-billing workflows and coordinate with internal teams to determine patient responsibility (note: role focuses on insurance-side collections; no direct patient outreach).\nDispute Resolution & Denial Management\nInvestigate claim denials or underpayments, obtain supporting clinical/billing documentation, and submit appeals or corrections as required.\nCollaborate with pharmacy staff and payer representatives to resolve disputes and implement corrective actions.\nTrack denial reasons and recommend process improvements to reduce recurrence.\nReporting & Compliance\nPrepare regular AR, aging, and collections activity reports for management review.\nAnalyze trends (denials, payer behavior, aging) and suggest optimizations to collection processes.\nEnsure all activities comply with HIPAA, payer policies, and internal billing best practices.\n
Skills, Knowledge and ExpertiseRequired:\nProven experience in medical billing and collections with direct experience managing out-of-network claims (home infusion pharmacy experience preferred).\nStrong knowledge of CPT and ICD-10 coding and payer requirements for infusion services.\nProficiency with Caretend and CPR Plus (or equivalent billing systems) and strong Excel skills.\nDemonstrated experience negotiating with insurance companies and resolving denials/underpayments.\nAbility to work Monday–Friday, 9:00 AM–5:00 PM PST (40 hours/week) and maintain a HIPAA-compliant remote workspace.\nWFH Set-Up:\nComputer with at least 8GB RAM, an Intel i5 core processor/AMD Ryzen 5 Processor and up.\nInternet speed of at least 40MBPS\nHeadset with an extended mic that has noise cancellation and a webcam\nBack-up computer and internet connection\nQuiet, dedicated workspace at home\n\n\nYour Superpowers:\nDeep knowledge of medical billing workflows, claims submission, appeals, and payer negotiations.\nProficient with Caretend, CPR Plus, MS Excel, Word, and Google Workspace.\nFamiliarity with coding (CPT, ICD-10) and payer-specific documentation requirements. Soft skills\nExcellent negotiation and written communication skills focused on insurer interactions.\nHigh attention to detail, organization, and ability to manage competing priorities.\nProblem-solver mindset and persistence in follow-up to drive collections.\nIntegrity and strict adherence to HIPAA and privacy regulations.\nYou should apply if...\nYou enjoy investigative work and are motivated by resolving denials and recovering revenue.\nYou are self-directed, reliable on a consistent PST schedule, and comfortable working remotely.\nYou value compliance, clear documentation, and collaborative problem solving with clinical and operational teams.\nYou’re patient, persistent, and able to negotiate professionally with payers without escalating to clinical teams unnecessarily.\n\nWhat to expect...
\nWork Setup:\nRemote position\nMust have a reliable internet connection and a quiet workspace\nRequired to provide own computer with Intel Core i5 or something similar or higher operating system\nWorking Hours:\n40 hours per week\nMonday–Friday, 9:00 AM–5:00 PM Pacific Time\nCompensation:\n$9 per hour\nNo benefits package included\n
Benefits
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