This is a remote position.
ABOUT ROCKSTAR
Rockstar is an industry-leading staffing company based in Arizona that helps healthcare businesses across the United States streamline operations by connecting them with skilled remote professionals. We partner with talented individuals from around the world, providing meaningful remote career opportunities that empower personal and professional growth.
At Rockstar, we are committed to placing team members who not only meet our clients' operational needs but who also reflect our core values of integrity, excellence, and long-term service. Every placement is an opportunity to make a meaningful difference for the practice, for patients, and for you.
ROLE OVERVIEW
Rockstar is seeking an experienced, bilingual (Spanish and English) Medical Billing Specialist to support an outpatient pediatric therapy practice on a full-time remote basis. This is a billing-first role built for professionals who know the full revenue cycle, not just one piece of it, and who take ownership of the financial health of the practice they support.
Denials management and appeals are the top priority of this role. Authorizations, insurance verifications, and referral and script follow-up are also core parts of the job, alongside claim submission, payment posting, accounts receivable follow-up, and reporting. Nevada Medicaid and its managed care plans make up most of the payer mix, and many of the families served speak only Spanish, so you will handle billing and phone calls in both languages.
KEY RESPONSIBILITIES
Denials Management & Appeals (Top Priority)
Review denied claims promptly, research denial reasons, and determine the appropriate course of action
Prepare and submit appeals with supporting documentation to secure proper reimbursement
Track denial trends and communicate findings to leadership to support process improvements
Follow up on appealed claims and rework as needed until resolution
Identify and help prevent future denials through accurate claim preparation and payer knowledge
Authorizations, Insurance Verification & Referral Follow-Up
Obtain and track prior authorizations, including renewals
Verify patient insurance eligibility and benefits, including re-verifications
Follow up on referrals and scripts to keep them current
Track plans of care and authorization-related billing requirements to keep claims billable
Claims Submission & Billing Operations
Process and submit insurance claims accurately and in a timely manner via EMR and clearinghouse systems
Manage the full billing cycle including claim creation, submission, tracking, and follow-up
Handle primary and secondary insurance claims, with a focus on Medicaid and managed care plans, including manual tracking requirements
Ensure all claims are submitted with correct coding, documentation, and payer-specific requirements
Resolve billing discrepancies by identifying root causes, correcting errors, and rebilling claims as needed
Ensure compliance with billing and coding regulations and maintain clean documentation for audit readiness
Accounts Receivable & Payment Management
Monitor and reconcile the accounts receivable ledger and maintain accurate, up-to-date A/R records
Follow up on outstanding balances, unpaid claims, and overdue accounts to support healthy cash flow
Post insurance and patient payments to accounts accurately and ensure proper allocation
Post zero-balance EOBs and process patient refunds as required
Generate and distribute monthly statements to patients and clients
Support collections workflows and escalate unresolved balances as appropriate
Generate billing and A/R reports for practice leadership on a regular basis
Patient Billing Communication(English and Spanish)
Make outbound calls to patients or guarantors in English or Spanish to follow up on outstanding balances, declined payments, or billing questions
Communicate billing details, payment options, and insurance responsibilities clearly and professionally in both languages
Respond to patient inquiries related to statements, claims, and account balances via phone and email
Document all billing-related communications and update patient records accordingly
Administrative & Reporting Support
Maintain accurate electronic patient records and billing documentation within the EMR
Generate key performance and billing reports for management review
Assist with administrative workflows, front desk backup duties, or special projects as assigned by the client
Maintain strict HIPAA compliance and patient confidentiality at all times
Requirements
Required
Fluent Spanish and English, spoken and written, with the ability to handle billing and phone calls in both languages
2+ years of hands-on medical billing experience. This is not an entry-level role
Medicaid billing experience (Nevada Medicaid and its managed care plans make up most of the payer mix)
Outpatient therapy billing experience (OT, PT, or speech), ideally pediatric
Proven experience managing the full revenue cycle: claim submission, payment posting, A/R follow-up, and denials
Strong working knowledge of insurance billing processes, payer requirements, and reimbursement rules
Experience with denials management, including researching, correcting, appealing, and tracking claims to resolution
Solid understanding of EOB interpretation, payment reconciliation, and accounts receivable principles
Ability to handle both primary and secondary insurance claims, including manual follow-up processes
Clear phone communication with patients and payers
Strong attention to detail, accuracy, and follow-through across all billing activities
Ability to work independently, self-direct daily tasks, and meet targets without close supervision
Reliable home office setup with a stable internet connection suitable for HIPAA-compliant remote work
Preferred
Prompt EMR experience is a strong plus
Familiarity with other healthcare EMR and billing platforms (e.g., WebPT, Raintree, or similar)
Experience with Medicare, workers' compensation, and out-of-network billing
Background working with multi-provider or high-volume clinic environments
Comfort with Google Workspace, Microsoft Office (Word/Excel), and cloud-based communication tools
WHAT WE LOOK FOR
Ownership:you treat the practice's A/R like your own and don't let claims sit unresolved
Expertise:you can read an EOB, identify why a claim was denied, and know exactly what to do next
Initiative:when something is off, you flag it, fix it, and help prevent it from happening again
Reliability:your client team counts on your daily output; you show up, you deliver, and you communicate clearly
Professionalism:you handle patient billing calls with patience, empathy, and accuracy
Benefits
Competitive salary commensurate with experience
Opportunities for professional development and long-term career growth
Work within a dynamic, collaborative, and supportive team environment
Stable, full-time remote employment with U.S.-based healthcare clients
Make a meaningful impact by helping practices serve their patients and communities
Originally posted on Himalayas