Virtual Medical Claims Assistant

Vintti is a forward-thinking staffing agency at the forefront of global talent solutions. We specialize in connecting US-based SMBs, startups, and firms with highly skilled professionals from Latin America. Our innovative approach breaks down geographical barriers, allowing businesses to tap into a rich pool of diverse talent while offering Latin American professionals access to exciting international career opportunities. Vintti builds bridges across continents, fostering cultural exchange and driving business growth through strategic staffing solutions.

A Virtual Medical Claims Assistant plays a critical role in the healthcare industry by managing and processing medical claims from remote locations. This role involves reviewing patients' insurance information, verifying coverage, and ensuring the accurate submission and follow-up of claims to insurance companies. The assistant serves as a liaison between medical providers, insurance companies, and patients, aiming to streamline the claims process, reduce errors, and expedite reimbursements. By efficiently navigating medical codes and billing procedures, Virtual Medical Claims Assistants help healthcare organizations optimize their revenue cycle management and maintain compliance with relevant regulations.

- High school diploma or equivalent; Associate's degree or higher in a related field preferred
- Previous experience in medical billing and claims processing
- Strong knowledge of medical terminology, billing codes (CPT, ICD-10), and insurance policies
- Proficiency with electronic claims submission systems and healthcare software
- Excellent attention to detail and accuracy in data entry
- Strong organizational and time management skills
- Effective communication skills, both written and verbal
- Ability to handle sensitive and confidential information in compliance with HIPAA regulations
- Problem-solving skills to resolve claims discrepancies and denied claims
- Basic proficiency in Microsoft Office (Word, Excel, Outlook)
- Ability to work independently and as part of a team
- Strong customer service skills for interaction with patients and healthcare providers
- Ability to stay updated on regulatory changes and industry best practices
- Flexibility to participate in training sessions and team meetings as required
- Reliable internet connection and appropriate workspace for a virtual role

- Review and process incoming medical claims for accuracy and completeness.
- Verify patient insurance coverage, benefits, and eligibility.
- Input and update patient demographics and claim information in the claims processing system.
- Communicate with healthcare providers to gather necessary documentation and clarify discrepancies.
- Submit claims to insurance companies via electronic submission or paper forms.
- Monitor and track the status of submitted claims until final resolution.
- Follow up on pending claims and address any issues with insurance companies.
- Prepare and submit documentation for appeals of denied claims.
- Ensure compliance with HIPAA regulations to maintain patient confidentiality.
- Generate and provide regular reports on claims status to management.
- Address patient inquiries regarding claim status, billing, and payment issues.
- Collaborate with the billing department to resolve discrepancies and payment issues.
- Maintain organized records of patient claims, payments, and all related correspondence.
- Stay informed about updates to insurance policies, billing codes, and relevant regulations.
- Participate in training sessions and team meetings to enhance claims processing efficiency.

The ideal candidate for the role of Virtual Medical Claims Assistant is a highly detail-oriented and analytical professional with a strong background in medical billing and claims processing, supported by a proven familiarity with medical terminology and billing codes such as CPT and ICD-10. They possess excellent proficiency with electronic claims submission systems and healthcare software, ensuring accurate and efficient processing of claims. With exceptional organizational and time management skills, they are adept at handling multiple tasks and meeting deadlines. Effective communication abilities, both written and verbal, are paramount, allowing them to seamlessly interact with patients, healthcare providers, and insurance companies. They are committed to maintaining patient confidentiality in full compliance with HIPAA regulations and demonstrate strong problem-solving skills to resolve claims discrepancies and denied claims effectively. Their proficiency in Microsoft Office applications, combined with a reliable internet connection and suitable workspace, equips them for the demands of a virtual role. The ideal candidate is a proactive individual who stays updated on regulatory changes and industry best practices, is adaptable to evolving processes, and is dedicated to continuous learning and professional development. A strong sense of accountability, reliability, and a customer service-oriented mindset underscore their commitment to patient satisfaction and team collaboration, setting them apart as an exceptional fit for this position.

- Review incoming medical claims for accuracy and completeness.
- Verify patient insurance coverage and benefits.
- Input and update patient information in the claims processing system.
- Communicate with healthcare providers to obtain necessary documentation and clarifications.
- Submit claims to insurance companies electronically or via paper forms.
- Track and monitor the status of submitted claims.
- Follow up with insurance companies on pending claims and resolve any issues.
- Appeal denied claims by preparing and submitting additional documentation.
- Maintain patient confidentiality in compliance with HIPAA regulations.
- Generate reports on claims status and provide updates to management.
- Respond to patient inquiries regarding claim status and billing issues.
- Coordinate with billing department to resolve discrepancies.
- Maintain organized records of patient claims, payments, and correspondence.
- Stay updated on changes in insurance policies, billing codes, and regulations.
- Participate in training sessions and team meetings to improve claims processing efficiency.

- Detail-oriented with strong analytical skills
- Excellent communication and interpersonal abilities
- Efficient time management and multitasking capabilities
- High level of accuracy in data entry and documentation
- Strong problem-solving and critical thinking skills
- Ability to work independently with minimal supervision
- Strong sense of accountability and reliability
- Adaptability to evolving processes and regulatory changes
- Proactive in following up on pending tasks and issues
- Committed to maintaining patient confidentiality
- Patient and empathetic in handling inquiries and concerns
- Team-oriented with the ability to collaborate effectively
- Technologically proficient with healthcare software and systems
- Dedicated to continuous learning and professional development
- Customer service-oriented with a focus on patient satisfaction

- Competitive salary range commensurate with experience
- Comprehensive health, dental, and vision insurance
- Flexible work schedule and remote work opportunities
- Paid time off (PTO) and holiday pay
- Professional development and training programs
- Opportunities for career advancement within the company
- Retirement savings plan with employer matching
- Performance-based bonuses and incentives
- Employee wellness programs
- Access to online courses and certifications
- Technology stipend for home office equipment
- Supportive and inclusive work environment
- Employee assistance programs (EAP)
- Tuition reimbursement for relevant courses