Job Description

Medical Billing Specialist
Location: Colombia
Compensation: USD 12,000 – 15,000 per year
Openings: 1
About the Company

The client is a U.S.-based ophthalmology and surgical practice specializing in eye care, laser vision correction, and surgical services. The organization operates a fast-paced clinical and surgical environment and places strong emphasis on accuracy, patient experience, and revenue cycle efficiency.

The Medical Billing Specialist is responsible for front-end and back-end revenue cycle support, with a strong focus on insurance eligibility, real-time patient estimates, authorizations, referrals, and medical records management for both clinic and surgical patients.

This role also supports patient communication by answering incoming calls and coordinating closely with clinical and billing teams to ensure timely, accurate billing and continuity of care.

Key Responsibilities

Insurance & Eligibility

• Verify insurance eligibility and benefits for all clinic and surgical patients

• Confirm coverage details, including deductibles, copays, coinsurance, and authorization requirements

• Identify non-covered services and clearly communicate patient financial responsibility

Patient Estimates & Out-of-Pocket (OOP) Quotes

• Generate real-time patient estimates for visits, diagnostics, procedures, and surgeries

• Calculate expected out-of-pocket costs based on insurance benefits and payer rules

• Explain financial responsibility clearly to patients and address related questions

• Document estimates accurately in the EHR / Practice Management system

• Escalate complex insurance scenarios or secondary coverage issues as needed

Authorizations & Referrals

• Obtain and track prior authorizations for in-office procedures, diagnostics, and surgeries

• Process and monitor referrals from PCPs and specialists

• Ensure all authorizations and referrals are accurate, active, and properly documented

• Proactively follow up to prevent delays or claim denials

Medical Records

• Request, receive, and upload medical records required for authorizations and billing

• Ensure documentation supports medical necessity and payer requirements

• Respond to medical record requests from insurance carriers and external providers

Billing Support

• Partner with billing and coding teams to support clean claim submission

• Assist with resolving eligibility-, authorization-, and estimate-related denials

• Maintain accurate patient demographic and insurance data

Patient Communication

• Answer incoming calls professionally and efficiently

• Assist patients with insurance questions, estimates, authorization status, and billing inquiries

• Route clinical or urgent calls appropriately

Administrative & Compliance

• Maintain HIPAA compliance and adhere to payer guidelines

• Document all insurance and patient financial interactions clearly

• Support front desk and clinical teams as needed to maintain patient flow

Qualifications

• Minimum 2+ years of experience in medical billing, eligibility, or revenue cycle management

• Strong experience with insurance verification, real-time estimates, authorizations, and referrals

• Surgical authorization experience preferred

• Proficiency with EHR and Practice Management systems

• Strong attention to detail and communication skills

Skills & Attributes

• Highly organized, efficient, and deadline-driven

• Comfortable handling high call volume and complex insurance scenarios

• Strong problem-solving skills and follow-through

• Patient-focused with a professional and clear phone presence