Certified Medical Claims Professional

3 days ago


Quezon City, National Capital Region, Philippines beBeeBilling Full time $50,000 - $70,000
Job Opportunity

The Medical Billing Specialist - Collection position is a key role within our healthcare team. This role involves monitoring the status of medical claims, thoroughly investigating rejections and denials, and documenting related account activities. The incumbent is responsible for posting adjustments and managing collections for various payers, including Medicare, Medicaid, Medicaid Managed Care, commercial insurance, and Workers' Compensation.

Job Details
  • Medical Billing Specialist - Collection
  • Permanent work from home
  • Monday to Friday | 10:00 PM to 7:00 AM Manila Time
  • *Following US Holidays
Responsibilities
  • Verify patient eligibility and benefits to ensure accurate coverage.
  • Submit claims in a timely and compliant manner.
  • Obtain prior authorizations to support claim approvals.
  • Monitor claim statuses and conduct A/R follow-up for prompt payment.
  • Research and resolve claim rejections and denials.
  • Generate and submit patient statements without patient interaction.
  • Document all account activities accurately and on time.
  • Post manual payments, apply adjustments, and manage collections from various payers.
  • Understand and apply Medicare, Medicaid, and commercial insurance requirements and payment methodologies.
  • Correctly record contractual adjustments based on payer contracts and government regulations.
  • Cultivate proficiency with billing systems to efficiently process claims.
  • Maintain up-to-date knowledge of billing and coding guidelines, payer contracts, and government regulations.
  • Collaborate with team members and providers for a positive work environment.
Qualifications
  • A strong background in end-to-end revenue cycle processes, including eligibility verification, charge review, claims submission, AR follow-up, denial management, collections, prior authorizations, payment posting, and handling medical records requests.
  • Experience in DME and using Apero is preferred.
  • An ability to work collaboratively with team members and healthcare providers.
  • A fast-paced work environment and occasional periods of above-average pressure.
  • Excellent customer service skills for interacting with various stakeholders.


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