# Bilingual Medical Biller & Eligibility Specialist

**Company:** [Staffing for Doctors](http://jobs.workable.com/companies/gAA8yfeXYbnEZ4xxJycpWn.md)
**Location:** Remote
**Workplace:** remote

[Apply for this job](http://jobs.workable.com/view/bdec396e-3d1d-4004-9b49-f02d97f559f3)

## Description

We are looking for a highly detailed, collaborative, and **Bilingual Medical Biller & Eligibility Specialist** to join a growing billing department. This role bridges the gap between front-end operations and back-end revenue cycle management, ensuring administrative accuracy before the patient even sees the provider.  
  
You must possess a deep understanding of U.S. medical insurance workflows, eligibility functions, and specific payer rules. Operating as a core liaison, you will work closely with our front desk and communications teams to secure clean claims, prevent denials, and provide a seamless onboarding experience for our patients.  
  
**Key Responsibilities:  
  
Insurance Verification & Eligibility Support**

-   **Real-Time Verifications:** Execute comprehensive insurance eligibility and benefit verifications for upcoming orthopedic appointments across major commercial, government (Medicare/Medicaid), and workers' compensation payers.
-   **Front-End Collaboration:** Assist the front desk and communications departments with front-end insurance processes, helping to troubleshoot active/inactive coverage issues prior to patient check-in.
-   **Patient Cost Estimation:** Identify deductibles, copays, and co-insurance requirements, accurately updating records so the front-desk team can collect correct point-of-service payments.

  
**Referral & Prior Authorization Management**

-   **Referral Acquisition:** Proactively track, request, and obtain required insurance referrals from primary care physicians (PCPs) and insurance portals.
-   **Payer Rules Adherence:** Stay up-to-date on shifting payer requirements to ensure all orthopedic imaging, injections, or specialist visits meet strict medical necessity guidelines.
-   **Data Integration:** Document and meticulously attach verified referrals and authorization codes within the **ModMed EMR** system to guarantee smooth billing continuity.

**Bilingual Patient & Internal Communications**

-   **Language Support:** Utilize fluent English and Spanish to assist the billing and communications teams when addressing complex insurance questions from patients.
-   **Workflow Continuity:** Document patient communication notes clearly within the system to maintain transparency across clinical and financial departments.

## Requirements

-   **Experience:** Minimum 2–3+ years of dedicated U.S. healthcare experience specializing in insurance verification, referrals, or medical billing.
-   **Linguistic Fluency:** Native or professional bilingual fluency in both **English and Spanish** (written and verbal).
-   **Workflow Competency:** Thorough, foundational knowledge of U.S. insurance structures, coordination of benefits (COB), and orthopedic billing workflows.
-   **Technical Setup:** Secure home office infrastructure with high-speed internet, a secondary monitor (preferred), and a noise-canceling headset.  
      
    **Preferred Qualifications:**
-   **EMR Mastery:** Hands-on, administrative experience utilizing **Modernizing Medicine (ModMed / EMA)** software.
-   **Specialty Knowledge:** Prior experience working specifically within an Orthopaedics, Physical Therapy, or Sports Medicine outpatient clinic.