Remote Outpatient Physical Therapy Billing Specialist

Company: Pro Vita Physical Therapy
Position: Medical Billing Support Specialist
Work Arrangement: Remote
Time Zone: Central Time Zone
Employment Type: Full-Time

About Pro Vita Physical Therapy
Pro Vita Physical Therapy is looking for someone with hands-on experience in U.S. outpatient physical therapy billing and revenue cycle management who can independently manage claims, A/R, denials, payer rejections, ERA posting, and payer follow-up.
The ideal candidate is detail-oriented, resourceful, comfortable working independently, and able to troubleshoot billing issues rather than simply identifying them.

Key Responsibilities

• Submit and monitor medical claims through electronic billing systems
• Review and resolve payer rejections and claim errors
• Manage assigned Accounts Receivable (A/R)
• Research and resolve denied claims
• Prepare and submit claim appeals
• Post Electronic Remittance Advices (ERAs)
• Review payer responses, payments, adjustments, and denials
• Navigate and utilize payer web portals
• Troubleshoot electronic claim and EDI-related issues
• Correct and resubmit claims when necessary
• Assist with manual claim submission and troubleshooting using CMS-1500 forms
• Research payer-specific billing requirements
• Review claims for billing accuracy, including CPT/HCPCS codes, modifiers, units, and payer requirements
• Maintain accurate billing documentation
• Follow up on outstanding claims and unpaid balances
• Meet established productivity, accuracy, and turnaround-time expectations

Required Qualifications

• Hands-on experience with US outpatient physical therapy billing and revenue cycle management
• Proficiency in Prompt EMR
• Proficiency in Waystar
• Knowledge of HIPAA requirements and ability to maintain patient confidentiality in a remote work environment
• Experience with Accounts Receivable (A/R)
• Experience resolving denied claims
• Experience preparing and submitting claim appeals
• Experience with ERA posting
• Experience with electronic claim submission
• Experience handling EDI transactions and payer rejections
• Proficiency navigating payer web portals
• Familiarity with CMS-1500 claim forms, including manual submission and claim troubleshooting
• Familiarity with basic CPT and HCPCS codes used in outpatient physical therapy
• Ability to troubleshoot billing and claim issues independently
• Ability to work under pressure and meet deadlines
• Strong attention to detail and accuracy
• Ability to work independently in a remote environment
• Ability to work during Central Time Zone hours
• Experience researching payer-specific billing policies and requirements
• Experience billing Medicare, TRICARE, and commercial insurance for outpatient physical therapy
• Experience handling complex denials and A/R follow-up
• Familiarity with common medical billing rejection and denial codes

Preferred Qualifications

• Familiarity with CMS NCCI Edits

Remote Technical Requirements

• Applicants must have a reliable and professional remote-work setup.

Required:

• Computer with at least 16 GB RAM
• Dual-monitor setup
• Reliable high-speed primary internet connection
• Backup internet connection
• Ability to install and use company-required security software, including VPN and multi-factor authentication (MFA)
• Reliable headset and microphone
• Quiet and professional workspace suitable for handling confidential work
• Applicants must be able to maintain reliable connectivity and remain productive throughout scheduled working hours.

Skills and Work Expectations

• Takes ownership of assigned claims and follows issues through resolution
• Proactively researches payer requirements and billing problems
• Prioritizes A/R based on urgency, timely-filing limits, and financial impact
• Documents billing actions and follow-up clearly and accurately
• Communicates problems, findings, and recommended solutions clearly
• Meets established productivity, accuracy, and turnaround-time expectations
• Escalates issues appropriately after reasonable troubleshooting has been completed

Who We Are Looking For
We are looking for someone who can step into an established billing workflow and contribute with minimal supervision. The ideal candidate takes ownership of assigned billing issues, researches problems thoroughly, and follows claims through resolution rather than simply identifying issues.
Proficiency in Prompt EMR and Waystar is required.

How to Apply
Please submit the following:

• Resume
• Years of U.S. outpatient physical therapy billing experience
• Years of experience using Prompt EMR
• Years of experience using Waystar
• Brief description of your experience with Medicare, TRICARE, and commercial insurance -billing
• Brief description of your experience managing A/R, denials, appeals, ERA posting, and claim rejections
• Confirmation that you meet all remote technical requirements
• Availability during Central Time Zone hours