Senior Medical Claims Specialist

2 days ago

General Santos, Soccsksargen, Philippines beBeeEpicMedicalBiller Full time ₱20,000 - ₱33,000
Epic Medical Biller Job Description

We are seeking a skilled Epic Medical Biller to join our revenue cycle management team. As an experienced professional in this field, you will play a crucial part in efficiently processing and managing claims.

Key Responsibilities:

  • Acknowledge medical charges, payments, and journal entries accurately on patient accounts.
  • Collaborate with insurance companies, healthcare providers, and patients to process claims effectively.
  • Verify patient registration data and insurance eligibility, along with benefits.
  • Prepare and transmit claims using Athena billing software.
  • Foster follow-up on unpaid claims and investigate denied claims for maximum reimbursement.
  • Expertly appeal denied claims, navigating complex insurance guidelines.
  • Maintain adherence to HIPAA regulations and industry standards.
  • Perform eligibility verification and obtain claim statuses from various insurance payers.
  • Review patient bills and superbills for precise charge entries.
  • Post Electronic Remittance Advice (ERA) and Explanation of Benefits (EOB) from diverse systems.

Required Skills and Qualifications:

  • Demonstrated experience as a Medical Biller, specifically with extensive hands-on experience using the Epic 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.
  • Experience with charge entry from superbills and posting ERA/EOB.
  • Strong commitment to maintaining HIPAA compliance.
  • Excellent attention to detail and organizational skills.
  • Effective communication skills, both written and verbal.

Nice-to-Haves:

  • Knowledge of credentialing processes.
  • Experience in denial management and appeals.

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