US Medical Coding and Billing Specialist

About Penbrothers

Penbrothers is an HR & remote talent management partner and one of the fastest growing companies in the Philippines. We provide talented Filipinos with global opportunities in high-growth startups and dynamic companies, from the comfort of their own homes.

About the Client

Our client is a multi-state ambulatory surgery center specializing in pediatric and special needs dentistry under general anesthesia. Their mission is to provide safe, compassionate, and efficient surgical care while creating a supportive environment for patients, families, and staff. To ensure quality care and regulatory compliance, we are seeking a detail-oriented Credentialing Specialist to join their growing team.

About the Role

The US Medical Coding and Billing Specialist is responsible for submitting medical claims to insurance companies, payors, and government programs, as well as following up on outstanding accounts. This role requires a strong understanding of dental and medical billing practices, attention to detail, and the ability to work in a fast-paced environment. The ideal candidate will have experience in multi-state billing, Medicaid, and private insurance claims.

What you'll do

• Prepare, review, and submit claims to insurance companies, Medicaid, and other payors.
• Verify insurance eligibility and coverage for scheduled procedures.
• Ensure accuracy of CPT, ICD-10, and HCPCS coding for services provided.
• Monitor claims for rejections or denials and take appropriate corrective action.
• Conduct timely follow-up on unpaid or underpaid claims.
• Post payments and adjustments to patient accounts in the billing system.
• Work closely with Site Directors, Finance, and Patient Services to resolve billing issues.
• Maintain compliance with federal and state regulations, including HIPAA.
• Provide excellent customer service when responding to patient and family billing inquiries.
• Identify opportunities to improve billing processes and reduce claim denials.

What You Bring

• At least 3 years of medical or dental billing experience, preferably in an ambulatory surgery or multi-site environment.
• Strong knowledge of CPT, ICD-10, HCPCS coding, and medical terminology.
• Familiarity with Medicaid, Medicare, and commercial insurance billing.
• Proficiency with electronic health record (EHR) and billing systems.
• Strong organizational skills and attention to detail.
• Ability to manage multiple tasks in a fast-paced environment.
• Excellent communication and problem-solving skills.
• Commitment to maintaining patient confidentiality and HIPAA compliance

Hiring Process

We utilize AI tools to enhance our hiring efficiency and ensure a fair evaluation of all candidates. As a result, candidates who passed our initial evaluations should expect an AI Interviewer as a component of our recruitment process. This is supervised by Human Talent Acquisition Experts who will also engage with you throughout your application journey.

What You'll Get

At Penbrothers, we are obsessed with creating positive employee experiences. Here you'll find an environment that nurtures learning and provides opportunities for growth. You'll have the opportunity to make an impact on fast-growing startups and dynamic companies.

• Meaningful work & Growth: We take every opportunity to stretch ourselves and deliver an excellent client experience.
• Employee as our biggest asset: We are genuinely invested in our people's career and welfare.
• Global reach & local impact: Get to work with high-growth startups and dynamic companies from the comfort of your own home.
• Powering global startups: We've created 1,400 Filipino jobs that empower global start-ups to focus on growth.