US Healthcare Medical Claims Specialist

3 days ago


Angeles City, Central Luzon, Philippines beBeeBilling Full time ₱240,000 - ₱396,000

**Medical Biller Role Overview**

We are seeking a skilled medical biller to support US healthcare client revenue cycle management using Athena billing software.

The successful candidate will possess strong analytical and problem-solving skills, as well as excellent communication and interpersonal abilities.

Responsibilities include:

  • Accurately posting medical charges, payments, and journal entries to patient accounts
  • Working directly with insurance companies, healthcare providers, and patients to process and manage claims
  • Verifying insurance eligibility and benefits, along with patient registration data

Additional responsibilities include:

  • Preparing and transmitting claims using Athena billing software
  • Proactively following up on unpaid claims and researching denied claims to ensure maximum reimbursement
  • Appealing denied claims, navigating complex insurance guidelines
  • Maintaining strict compliance with HIPAA regulations and industry standards
  • Performing eligibility verification and obtaining accurate claim statuses from various insurance payers
  • Reviewing patient bills and reading superbills for precise charge entries
  • Posting Electronic Remittance Advice ERA and Explanation of Benefits EOB from diverse systems
Required Skills and Qualifications
  • Proven experience as a Medical Biller, specifically with extensive hands-on experience using Athena billing software/EMR
  • Solid understanding of US healthcare insurance guidelines and medical billing best practices
  • Demonstrated ability to perform eligibility and benefit verification
  • Proficiency in obtaining claim statuses and navigating payer portals


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