Virtual Pediatric Medical Biller & Front Office Administrator

We are seeking an experienced, warm, and highly organized Virtual Pediatric Medical Biller & Front Office Administrator to serve as the central operational backbone for a growing pediatric therapy clinic offering Speech, Physical, and Occupational Therapy. In this full-time remote role, you will independently manage the clinic’s entire front-office workflow and revenue cycle—supporting a dedicated team of 7 therapists (Speech, PT, and OT) by handling parent inquiries, coordinating multi-provider schedules, verifying benefits, submitting claims, and aggressively resolving claim denials.

Because you will be the primary voice of the practice for parents, families, and insurance representatives, accent-neutral, fluent English communication with a patient, friendly phone presence is an absolute requirement. Additionally, the clinic is preparing to transition its EMR from SimplePractice to Prompt, making hands-on experience with either or both platforms—alongside Weave for communications—a key advantage for streamlining billing workflows and supporting staff onboarding.

Working Environment & Core Schedule

• Role Title: Virtual Pediatric Medical Biller & Front Office Administrator
• Specialty: Pediatric Therapy (Speech-Language Pathology, Physical Therapy, Occupational Therapy)
• Status: Full-Time (40 Hours / Week)
• Schedule:
• Monday – Thursday: 8:00 AM – 6:00 PM CST (with a 1-hour unpaid lunch break from 12:00 PM – 1:00 PM CST)
• Friday: 8:00 AM – 12:00 PM CST
• Core Technology Stack: SimplePractice EMR, Prompt EMR (upcoming transition), Weave (VoIP, Faxes & Messaging), Insurance Payer Portals
• Primary Scope: Full-Cycle Medical Billing & Denial Resolution, Insurance Eligibility & Prior Authorizations, Patient Scheduling, and Front-Office Communications

Top Daily Tasks

1. Patient & Family Communications: Answer incoming phone calls, manage faxes and text messages via Weave, and respond to parent/family inquiries with warmth and clarity.
2. Multi-Provider Scheduling & Coordination: Book, confirm, and reschedule therapy appointments across 7 Speech, PT, and OT providers while maintaining accurate daily calendars.
3. Medical Billing & Claims Submission: Prepare, scrub, and submit clean therapy claims electronically, ensuring accurate therapy CPT coding and modifier application.
4. Denial Management & Payor Follow-Up: Investigate rejected or unpaid claims, contact insurance carriers directly to resolve adjudication bottlenecks, and submit corrected claims promptly.
5. Insurance Eligibility & Prior Authorizations: Verify active patient benefits prior to evaluations/treatments and submit/track therapy prior authorizations through payor portals.
6. Payment Collection & Billing Administration: Process patient copays, deductibles, and balances, post insurance payments, and keep patient financial ledgers reconciled.

Core Responsibilities

• End-to-End Front Desk Administration: Serve as the sole front-office point of contact—managing inbound/outbound phone calls, digital faxes, and patient portal messages through Weave.
• Therapy Appointment Coordination: Manage recurring therapy schedules, handle cancellations/reschedules, and maintain high schedule utilization across full-time and part-time Speech, PT, and OT clinicians.
• Claims Processing & Denial Resolution: Own the complete billing lifecycle—submitting claims, auditing rejections, calling payors to untangle complex denials, and reducing AR backlog.
• Benefits Verification & Authorizations: Confirm therapy visit limits, deductibles, and referral/authorization requirements before care is rendered to prevent non-covered service write-offs.
• EMR Operations & Transition Support: Manage daily workflows in SimplePractice and assist with transitioning billing and scheduling operations to Prompt, helping train and support clinical staff on the new platform.

Requirements

• 3+ Years U.S. Medical Practice Experience: Proven background managing both front-office administration and full-cycle medical billing for a U.S.-based healthcare clinic.
• Claims Submission & Denial Mastery: Demonstrated ability to submit clean claims, read EOBs/ERAs, investigate complex claim denials over the phone with payors, and recover unpaid revenue.
• Insurance Verification & Authorization Experience: Hands-on proficiency verifying commercial and government insurance benefits and managing therapy prior authorizations.
• Accent-Neutral English & Warm Phone Demeanor: Exceptional spoken and written English with minimal to no noticeable accent, paired with a patient, empathetic, and friendly communication style suited for parents and families.
• Therapy CPT & Appointment Familiarity: Solid working knowledge of therapy-related CPT codes (Speech, PT, OT evaluations and timed/untimed treatment codes) and recurring therapy scheduling.
• Exact Schedule Commitment: Full availability to work 40 hours per week on the clinic’s split schedule (Mon–Thu 8:00 AM – 6:00 PM CST with a 1-hour lunch break, and Fri 8:00 AM – 12:00 PM CST).
• HIPAA-Compliant Remote Workspace: Private, quiet home office with a lockable door, high-performance PC/Mac, high-speed primary internet, backup internet/power solutions, and a noise-canceling headset.

Preferred Qualifications

• Direct hands-on experience using Prompt EMR (strong advantage for leading the clinic’s upcoming software transition and staff training) and/or SimplePractice.
• Experience navigating Weave for VoIP phone handling, two-way texting, and digital fax management.
• Prior experience working specifically in a pediatric therapy clinic (Speech, Physical, or Occupational Therapy).

Ideal Candidate Profile

You are a self-sufficient, warm, and detail-driven healthcare administrator who effortlessly balances front-desk hospitality with sharp billing execution. You make parents feel welcomed on the phone, keep seven therapy schedules running like clockwork, and possess the tenacity to dig into insurance denials and recover every dollar the clinic earns.