Medical Records & Billing Administrator
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AI Summary
The role involves processing medical records requests, managing payer mail, and handling billing refunds and reconsiderations. It also supports the Revenue Operations team with audit documentation and the identification of workflow inefficiencies.
Are you looking for a role in a company that's solving one of the greatest challenges of our lifetime? Ophelia helps people end their opioid use and restore their quality of life with respect for their time and dignity. Our mission is to make evidence-based treatments for opioid use disorder (OUD) accessible to everyone... and we're looking to bring more people onto our team to help us achieve it.
Ophelia is a venture-backed, healthcare startup that helps individuals with OUD by providing FDA-approved medication and clinical care through a telehealth platform. Our approach is discreet, convenient, and affordable. We've been successfully operating in 14 states for almost six years and we're excited to continue our growth. We are a team of physicians, scientists, entrepreneurs, researchers and White House advisors, backed by leading technology and healthcare investors working to re-imagine and re-build OUD treatment in America.
About the Role
The Medical Records & Billing Administrator is responsible for the day-to-day processing of medical records requests, incoming payer mail, and billing-related refunds and reconsiderations. This role is critical to maintaining timely compliance with payer and regulatory requirements while supporting the broader Revenue Operations team's audit and billing functions.
Key Responsibilities
- Process medical records requests ensuring timely and accurate turnaround
- Manage incoming payer mail, including sorting, routing, and responding to time-sensitive requests
- Process billing-team refunds, payer reconsiderations, and manual 837 claim pulls and postings
- Collaborate with the Internal Audit & Compliance Associate to support audit-related documentation and record retrieval
- Identify and flag process inefficiencies or recurring issues in medical records or billing workflows
- Support other billing team functions as workload requires
What we're looking for
- High school diploma or equivalent required; associate degree or relevant certification (e.g., medical records, billing/coding) preferred
- 1–2+ years of experience in medical records, healthcare billing, or a related administrative healthcare role preferred
- Familiarity with payer request processes, medical billing terminology, and claims workflows (e.g., 837 claims) a plus
- Strong attention to detail and ability to manage high-volume, deadline-driven work independently
- Comfortable working in a remote environment with minimal day-to-day supervision
- Strong written and verbal communication skills
- Working knowledge of HIPAA compliance and confidentiality standards
This is a remote position requiring reliable internet access and a private workspace suitable for handling confidential patient information in compliance with HIPAA standards.
Our Benefits Include
- Competitive medical, vision, and health insurance (many plans are fully covered for the employee!)
- Start with 20 days (4 weeks) of PTO, increasing to 5 weeks after 2 years and 6 weeks after 5 years of tenure
- 10 company holidays
- Work From Home Stipend
- 401k Contribution Platform
- Additional benefits offered through our benefits provider such as life insurance, short and long term disability, financial wellness, virtual primary care, among others!
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Ophelia Compensation Overview
- We set compensation based on the level and skills required for the role. We value pay transparency and equity, and are committed to fair pay. In order to prevent pay disparities and reduce time spent in negotiations, we take a “first and best” offer approach: this means we’re not holding any compensation back from our candidates, and you can feel confident that our pay is fair and does not vary based on the strength of someone’s negotiation skills.
- Compensation is dynamic at Ophelia: as long as the company performs well and meets our targets, there will be opportunities for increased compensation annually. We’re happy to discuss this approach and our bands if you have questions during the interview process.
Compensation Range
$50,000—$50,000 USD
Interested in learning more about Ophelia and this role? Apply to work with us!
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