Medical Billing Specialist

18 hours ago

Makati, Philippines Sourcefit Full time

Overview

We are actively seeking an experienced and highly motivated Medical Billing Specialist (AR and Collections) to join our dynamic team. The successful candidate will play a crucial role in managing our collection processes for TDD services. The tasks include contract analysis, reimbursement, denial management, appeals, and resolving billing-related issues with insurance companies or other responsible parties for services rendered. The ideal candidate should possess in-depth knowledge of billing and collection practices and have a strong track record in resolving complex financial situations.

Job Details
  • Medical Billing Specialist (AR and Collections)
  • Permanent work from home
  • Monday to Friday | 8 AM to 5 PM Central Time (CST)
Responsibilities
  • Recognize and support patients’ rights and responsibilities in the performance of job duties, while respecting their privacy and confidentiality.
  • Follow up on submitted invoices to ensure prompt and timely payment, escalating issues as necessary.
  • Evaluate payments/denials received for correctness and ensure they are applied accordingly.
  • Identify bad debt write-offs and A/R adjustments. Initiate write-offs and adjustments in accordance with established policies and procedures.
  • Detect any overpayments and/or duplicate payments and investigate and resolve accordingly.
  • Process refund requests, in accordance with policies and procedures.
  • Maintain contact with other departments to obtain the patient or insurance information needed for claim payment.
  • Understand all procedures within regulatory mandates.
  • Ensure that the collection operations are conducted in a manner that is consistent with overall department protocol and follows Federal, State, and payer regulations, guidelines, and requirements.
  • Make calls to troubleshoot payment discrepancies and establish resolution.
  • Document, in detail, phone calls, phone numbers, persons spoken to, and call details on a consistent basis.
  • Consistently look for areas to maximize claim reimbursement.
  • Resolve issues that caused a denial within 5 days of receipt of denial.
  • Maintain strictest confidentiality; adhere to all HIPAA guidelines/regulations.
  • Understand NDC (National Drug Code) numbers, metric quantities, and knowledge of infusion supplies.
  • Maintain a broad range of knowledge of insurance plans, medical terminology, billing procedures, government regulations, and medical codes.
  • Share knowledge gained with other staff members and work as a team member.
  • Interact with others in a positive, respectful, and considerate manner.
  • Perform other job-related duties as assigned.
Qualifications
  • A high school diploma or general education degree (GED) equivalent.
  • At least 3 years of medical billing and collections experience.
  • Home Infusion experience, hospital, or chemotherapy experience is a plus.
  • Experience in calculating drug units and intrathecal Pain Management is a plus.
  • Ability to recognize, evaluate, and exercise good judgment in solving complex situations and advising by laws and regulations.
  • Excellent verbal and written communication and relationship-building skills with an ability to prioritize, negotiate, and work with a variety of internal and external stakeholders.
  • Strong work ethic with personal qualities of integrity and credibility.
  • Self-directed, detail-oriented, conscientious, organized, and able to follow through.
  • Ability to deal in an organized manner with problems involving multiple variables within the scope of the position.
  • Tolerance of frequent interruptions and distractions from staff and other internal support teams.
  • Proficiency in Microsoft Office, including Outlook, Word, and Excel.
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