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Senior Medical Billing Specialist

4 weeks ago


Bulacan, Philippines Connext Full time

Talent Acquisition Specialist | Passionate about People and Progress | Actively hiring Medical Billers, Data Entry Specialists, and Salesforce

Connext Global Solutions is a dedicated team of business process outsourcing experts and innovators, with experience in supporting world-class companies in Title and Escrow, Healthcare, Produce Distribution, Retail and Fashion, Design Consulting, and Finance.

We are currently looking for a Senior Medical Billing Specialist who will be working with Connext's Client in the United States of America

What's in it for you?

  • Competitive compensation
  • Life insurance
  • HMO Insurance
  • Great company culture
  • Annual Merit Increase
  • 25% Night Differential
  • Work from home with company provided equipment

What is the job?

The Senior Medical Billing Specialist is responsible for supporting US commercial medical insurance processes by performing benefit checks, eligibility verification, prior authorizations, and claim denial resolution. The role requires strong knowledge of major payers, troubleshooting insurance issues, and advocating effectively with payers.

  • Perform insurance benefit checks and eligibility verification for scheduled patients.
  • Determine patient responsibility for upcoming visits, including deductibles, copays, coinsurance, and medical vs. behavioral health differences.
  • Update patient responsibility figures in the EMR and validate charges prior to visits.
  • Run daily morning check-ins to confirm eligibility, copays, and initiate system collection of payments.

Required Qualifications:

  • Minimum of four (4) years of experience with US commercial medical insurance.
  • Must have a stable employment history.
  • Demonstrates working knowledge of major payers: BCBS, UHC, Cigna, Aetna.
  • Demonstrates working knowledge with medical billing, claims/denials, insurance verification, and prior authorization.
  • Understands deductibles, copays, coinsurance, medical vs. behavioral health coverage, and prior authorization requirements.

Connext Global Solutions is an equal opportunities employer and welcomes applications from diverse candidates.

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