Medical Claims Specialist

3 days ago


Iloilo City, Western Visayas, Philippines TMDPH INC Full time
Overview

TMDPH Inc. is a leading healthcare organization seeking an experienced Medical Biller to join our team.

Job Summary

We are looking for a highly skilled and detail-oriented individual to play a critical role in ensuring accurate and timely billing processes for medical services provided to patients.

Key Responsibilities:
  • Review and verify accuracy of patient information, diagnoses, and medical procedures for proper coding and billing.
  • Prepare and submit medical claims to insurance companies and other third-party payers accurately and within established timelines.
  • Follow up on outstanding claims, denials, and discrepancies to ensure timely and complete reimbursement.
  • Process and track payments received from insurance companies, patients, and other sources.
  • Investigate and resolve billing discrepancies or errors, working collaboratively with internal and external stakeholders.
  • Maintain up-to-date knowledge of medical billing regulations, coding guidelines, and insurance requirements.
  • Communicate with patients, insurance companies, and other relevant parties to address billing inquiries, provide explanations of benefits, and ensure accurate billing information.
  • Maintain patient confidentiality and adhere to ethical standards when handling sensitive financial and medical information.
  • Assist with generating financial reports and analyzing billing data for insights into revenue cycles and trends.
  • Collaborate with healthcare providers, administrative staff to ensure effective billing operations.
Requirements:
  • Bachelor's Degree in any field.
  • An associate's degree or certification in Medical Billing and Coding is an advantage but not required.
  • Proficient understanding of medical billing procedures, insurance claims, and coding systems (CPT, ICD-10, HCPCS).
  • Familiarity with billing software and electronic health record (EHR) systems.
  • Strong attention to detail and analytical skills to review and process billing information accurately.
  • Excellent written and verbal communication skills for effective interaction with patients and insurance representatives.
  • Ability to work independently, manage priorities, and meet billing deadlines.
Compensation:

The estimated salary range for this position is $45,000 - $65,000 per year, depending on experience and qualifications.



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