Healthcare Billing Specialist (ASC Billing)

Job Post: Healthcare Billing Specialist (ASC Billing)

Position Code: GJ-MHS

Position Type: Full-Time (40 hours per week)

Work Hours: 9:00 AM – 5:00 PM PDT

Work Days: Monday to Friday

Salary: Starting at $6 - 7 per hour (depending on experience)

We are seeking a detail-oriented and experienced Healthcare Billing Specialist specializing in Ambulatory Surgery Center (ASC) billing to support accurate claims processing, efficient revenue cycle management, and timely reimbursement for U.S. healthcare providers.

In this role, you will primarily handle ASC medical billing , including surgical claims submission, insurance verification, payer follow-ups, denial management, appeals, and accounts receivable. You will ensure claims are accurately processed according to ASC-specific billing requirements, coding guidelines, and payer policies.

The ideal candidate has strong hands-on experience with ASC billing workflows , outpatient surgical procedures, CPT/HCPCS codes, modifiers, and reimbursement processes . Experience with home health billing, Notices of Admission (NOAs), and ALORA software is an added advantage.

Beyond billing responsibilities, you will also provide administrative, executive, and patient communication support to help maintain efficient daily operations.

If you are a proactive medical billing professional who enjoys resolving complex claims, improving reimbursement outcomes, and supporting healthcare providers, we'd love to hear from you!

Key Responsibilities

ASC Billing & Revenue Cycle Management (Top Priority)

• Manage full-cycle Ambulatory Surgery Center (ASC) billing, including claims preparation, submission, tracking, follow-ups, denials, appeals, and reimbursement resolution.

• Prepare, review, and submit claims for outpatient surgical procedures, ensuring accuracy and compliance with payer requirements.

• Apply knowledge of ASC-specific CPT/HCPCS codes, modifiers, and billing guidelines to identify potential claim errors.

• Verify that surgical claims include accurate procedure information, appropriate modifiers, and required supporting documentation.

• Navigate Medicare, Medicaid, and commercial insurance billing requirements applicable to ASC services.

• Review payer-specific reimbursement guidelines, including applicable ASC payment methodologies.

• Investigate rejected, denied, underpaid, or unpaid surgical claims and determine appropriate corrective actions.

• Process corrected claims, reconsiderations, and appeals to resolve reimbursement discrepancies.

• Manage accounts receivable (AR) and follow up on outstanding ASC claims.

• Identify coding-related discrepancies, missing documentation, and potential reimbursement issues.

• Verify patient insurance eligibility, coverage, and benefits before claim submission when needed.

• Coordinate with insurance representatives and internal teams to resolve billing concerns.

• Ensure claims are accurate, complete, and compliant with applicable payer requirements.

• Meet the daily productivity target of 45 claim follow-ups per day.

• Upload, track, organize, and maintain Explanation of Benefits (EOBs).

• Maintain accurate records of submitted, pending, denied, corrected, and resolved claims.

Home Health Billing Support

• Assist with home health agency billing and revenue cycle management as needed.

• Review and process Notices of Admission (NOAs) for accuracy, completeness, and timely submission.

• Support home health claims submission, insurance follow-ups, and denial resolution.

• Utilize ALORA for billing, documentation, and claim tracking when applicable.

• Ensure home health billing activities follow applicable payer requirements.

• Maintain accurate documentation and records of home health billing activities.

Administrative & Executive Support

• Prepare and maintain billing reports, spreadsheets, claims trackers, and documentation.

• Assist with administrative overflow and other operational responsibilities.

• Provide executive and administrative support to ensure smooth daily operations.

• Maintain organized records and communicate outstanding tasks or concerns promptly.

• Support workflow improvements to increase billing efficiency and accuracy.

Patient Communication & Reception Support

• Answer and manage inbound and outbound calls using Nextiva VoIP.

• Respond to patient inquiries professionally, accurately, and promptly.

• Provide receptionist-level support when needed.

• Communicate with patients, insurance representatives, and internal staff regarding billing-related inquiries.

• Maintain patient confidentiality and provide professional, empathetic communication.

Top 3 Priorities

• Accurate ASC Claims Processing & Submission

Ensure outpatient surgical claims are prepared and submitted accurately using appropriate CPT/HCPCS codes, modifiers, supporting documentation, and payer-specific billing requirements.

• ASC Denial Management, Accounts Receivable & Reimbursement

Proactively manage outstanding surgical claims, denials, rejections, underpayments, and appeals. Conduct consistent payer follow-ups while meeting the daily target of 45 claim follow-ups to support timely reimbursement.

• Billing Compliance, Documentation & Operational Support

Maintain accurate billing records, follow ASC-specific payer requirements, identify documentation discrepancies, and support administrative operations while ensuring HIPAA compliance.

What Success Looks Like

A successful Healthcare Billing Specialist consistently demonstrates

• Accurate and timely ASC claims submission.

• Strong knowledge of outpatient surgical billing requirements.

• Effective resolution of denied, rejected, and underpaid ASC claims.

• Consistent management of accounts receivable and outstanding reimbursements.

• Achievement of the daily KPI of 45 claim follow-ups.

• Accurate application of relevant CPT/HCPCS codes, modifiers, and payer requirements.

• Organized and complete EOB documentation and claims tracking.

• Proactive identification of billing errors and reimbursement discrepancies.

• Reliable administrative support and professional patient communication.

• Consistent compliance with HIPAA and healthcare billing policies.

Tools & Platforms

Experience with the following is preferred

Billing, EHR & Practice Management Systems

• ALORA

• eClinicalWorks (eCW)

• AdvancedMD

• DrChrono

• WebPT

• Fair Bill

• Elation

• TheraBill

Communication Tools

• Nextiva VoIP

Requirements

Required Skills & Experience

• Proven hands-on experience in U.S. Ambulatory Surgery Center (ASC) billing.

• Strong understanding of ASC billing workflows, outpatient surgical claims, and revenue cycle management.

• Experience preparing, submitting, tracking, and following up on ASC claims.

• Working knowledge of CPT, HCPCS, ICD-10, and ASC-related modifiers.

• Familiarity with Medicare and commercial insurance billing requirements for outpatient surgical procedures.

• Experience managing denied, rejected, underpaid, and unpaid medical claims.

• Hands-on experience with accounts receivable, insurance follow-ups, claim corrections, and appeals.

• Ability to identify billing discrepancies, coding-related errors, missing documentation, and reimbursement issues.

• Experience verifying insurance eligibility, coverage, and benefits.

• Familiarity with EOBs, payment discrepancies, and claims tracking.

• Ability to maintain accurate records and meet daily productivity targets.

• Strong understanding of payer-specific billing requirements and reimbursement guidelines.

• Excellent attention to detail, analytical thinking, and problem-solving skills.

• Strong organizational and multitasking abilities.

• Excellent written and verbal English communication skills.

• Ability to work independently, manage competing priorities, and adapt to changing workflows.

• Knowledge of HIPAA compliance and patient confidentiality requirements.

Preferred Qualifications

• Experience supporting multiple Ambulatory Surgery Centers or outpatient surgical specialties.

• Familiarity with ASC Medicare payment methodologies and commercial payer reimbursement processes.

• Experience resolving complex ASC denials, underpayments, and coding-related reimbursement discrepancies.

• Knowledge of surgical procedure coding and applicable modifiers.

• Experience with home health agency billing and NOA review and processing.

• Familiarity with ALORA or other home health billing platforms.

• Experience using eClinicalWorks, AdvancedMD, DrChrono, WebPT, Fair Bill, Elation, or TheraBill.

• Experience using Nextiva or similar VoIP systems.

• Previous experience supporting U.S.-based healthcare billing organizations remotely.

• Experience providing administrative, executive, or patient reception support.

Ideal Candidate Profile

We're looking for someone who is

• Experienced in ASC Billing: Has practical knowledge of outpatient surgical claims, payer requirements, and reimbursement workflows.

• Detail-Oriented : Carefully reviews claims, codes, modifiers, and documentation for accuracy.

• Proactive: Identifies billing discrepancies, denials, and reimbursement issues before they escalate.

• Analytical: Can investigate complex claims and determine appropriate resolutions.

• Organized: Effectively manages outstanding claims, follow-ups, and deadlines.

• Pr oductive: Consistently meets billing follow-up targets without compromising accuracy.

• A daptable : Comfortable handling additional home health billing or administrative responsibilities when needed.

• Reliable: Takes ownership of assigned tasks and communicates progress transparently.

• Patient-Focused: Maintains professional and empathetic communication with patients and healthcare teams.

• Compliance-Conscious: Prioritizes HIPAA, payer requirements, and accurate billing practices.

Basic Requirements

• Must be proficient in speaking and writing clear, professional English.

• Must have relevant hands-on experience in U.S. medical billing, particularly ASC billing.

• Must be able to submit an NBI Clearance and/or Local Police Clearance before onboarding (mandatory).

• Must be available for video meetings with camera on when required.

• Must be available to work full-time, Monday through Friday, from 9:00 AM to 6:00 PM Eastern Time.

Technical Requirements

• Computer: Reliable laptop or desktop computer.

• Internet: Stable high-speed internet connection (minimum 25 Mbps).

• Audio: Noise-canceling headset.

• Video: Working webcam for virtual meetings.

• Workspace: Quiet and professional work environment.

Benefits

• Dedicated HR & Contractor Support Team: Access to world-class support for questions, guidance, contract matters, and client communication.

• Premium VPN Access (Optional): A secure VPN license can be provided upon request to enhance privacy and security for client-related tasks.

• HIPAA & Cybersecurity Training + Certification (Provided): Access to our internal HIPAA compliance training, cybersecurity modules, and certification to help you confidently handle PHI for U.S. healthcare clients.

• Top 1% VA Performance Training: Access to our proprietary training on communication, client management, productivity systems, and best practices to help you become a top-performing VA and increase long-term client retention.

• Client-Approved U.S. Holidays: Contractors may take U.S. holidays off according to the client’s needs and schedule.

• Client-Approved Paid or Unpaid Time Off: Time off may be granted by your client. Paid time off is optional and only if offered by the client.

• Access to Tools & Resources: Templates, workflow guides, productivity tools, and client-specific SOP support to help you perform at your best.

• Optional Performance-Based Incentives: Some clients may offer bonuses, incentives, or increased hours based on your performance.

These are optional resources and client-approved allowances available to you as an independent contractor. Any resources, training, or allowances listed are optional contractor perks and not employee benefits.