Revenue Cycle Operations Specialist

19 hours ago

Cebu City, Central Visayas, Philippines beBeeBilling Full time ₱250,000 - ₱450,000

Medical Billing Specialist Job Summary

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The Medical Billing Specialist is responsible for ensuring the accurate submission of medical claims to insurance companies and managing accounts receivable. The role requires a deep understanding of medical billing and coding processes, insurance policies, and the ability to communicate effectively with patients and insurers.

">Key Responsibilities">
  • Claim Submission & Processing: Prepare and submit medical claims to insurance companies, ensuring accuracy and adherence to coding guidelines (CPT, ICD-10, HCPCS).
  • Billing & Coding: Verify patient billing and coding for procedures, diagnoses, and treatments to ensure correct reimbursement.
  • Accounts Receivable Management: Monitor accounts for unpaid balances, follow up on outstanding claims, and resolve denied or rejected claims through appeals process.
  • Insurance Verification: Verify patient insurance coverage, benefits, and eligibility prior to services being rendered.
  • Payment Posting: Post insurance and patient payments to the appropriate accounts, ensuring accurate allocation of funds.
  • Patient Communications: Handle patient inquiries related to their bills, explain charges, and assist in setting up payment plans if necessary.
  • Regulatory & Compliance: Ensure billing procedures comply with industry regulations, including HIPAA, and keep up-to-date with changes in medical billing and coding standards.
  • Documentation & Reporting: Maintain accurate billing records and reports, ensuring timely filing and proper documentation for audits and compliance.

Required Skills & Qualifications:

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  • Education: High School Diploma or equivalent required; certification in medical billing or coding (e.g., CPC, CCS).
  • Experience: 1-3 years of experience in medical billing, preferably in a healthcare setting.
  • Knowledge: Strong understanding of medical billing and coding practices, insurance guidelines, and HIPAA.
  • Skills: Proficient in medical billing software and electronic health records (EHR) systems; Excellent attention to detail and organizational skills; Strong communication skills for dealing with insurance companies and patients.

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