medical biller/coder and pre-authorization verifier

MEDICAL BILLER/CODER AND PRE-AUTHORIZATION VERIFIER (REMOTE)

Company: TeamFicient -

About Us: At TeamFicient, we are a dynamic team of highly experienced professionals dedicated to providing tailored solutions that meet the unique needs of our clients. We are currently seeking a skilled Medical Biller/Coder & Pre-Authorization Verifier to join our team and play a crucial role in maintaining the efficiency and accuracy of our day-to-day operations.

Position: Medical Biller/Coder and Pre-authorization Verifier (Remote)

Salary Range: TBD (Negotiable for highly experienced candidates)

Working Hours: 9 hours a day (8 working hours with a 1-hour break)

Time Range: Between 7 AM – 7 PM CST (Graveyard shift)

Days Off: TBD (2 days per week)

What's In It for You?

• Competitive Salary with potential increases based on performance
• Full-Time Position (40 hours/week)
• Paid Training and opportunities for additional bonuses
• Government Contributions: SSS, PhilHealth & PAG-IBIG
• Comprehensive Compensation: Holiday pay, overtime pay, night differential pay, & 13th month pay
• Leave Credits & HMO after regularization

Job Responsibilities:

Pre-Authorization

• Process and submit authorization requests for procedures and specialist referrals to insurance companies.
• Monitor and follow up on pending approvals to ensure timely authorizations.
• Communicate with healthcare providers and insurers to gather required documentation and resolve issues.
• Maintain accurate records of authorizations and ensure compliance with insurance regulations.

Medical Biller/Coder

• Prepare and submit accurate medical claims to insurance companies.
• Verify patient insurance and ensure proper coding of services using CPT and ICD-10 codes.
• Follow up on unpaid or denied claims and handle appeals when necessary.
• Communicate with insurance companies and healthcare providers to resolve billing discrepancies.

Key Responsibilities:

• Excellent communication and organizational skills.
• Strong knowledge of medical terminology, insurance processes, and authorization procedures.
• Ability to multitask and prioritize workload in a fast-paced environment.
• Proficient in using electronic medical records (EMR) systems and other relevant software.
• Attention to detail and a proactive approach to problem-solving.
• Ability to work effectively both independently and as part of a team.
• Maintain detailed records of billing activities and ensure compliance with healthcare regulations.

Qualifications:

Education

• High school diploma or equivalent (required).
• Associate's degree or certificate in medical coding, billing, health information management, or a related field (preferred).

Certifications

• Certified Professional Coder (CPC) from the AAPC (optional but preferred).
• Certified Coding Specialist (CCS) from AHIMA (optional but preferred).
• Certified Medical Reimbursement Specialist (CMRS) from AMBA (optional but preferred).

Experience

• Previous experience in medical coding and billing ( at least one year)
• Experience with electronic health records (EHR) and practice management software
• Must have experience working with US companies in this field

Technical Skills

• Proficiency in ICD-10, CPT, and HCPCS coding systems.
• Familiarity with billing processes and insurance claims procedures.
• Strong computer skills, including proficiency in healthcare software and Microsoft Office Suite.

Soft Skills

• Excellent attention to detail and accuracy.
• Strong organizational and time management skills.
• Effective communication skills for interacting with healthcare providers, insurance companies, and patients.
• Ability to work independently and as part of a team.
• Understanding of confidentiality and ethical standards in handling patient information.

System Requirements:

• Desktop/Laptop with Intel Core i5 or higher
• Minimum 4GB RAM for multitasking
• A dedicated workstation free from noise and distractions
• Backup Internet Connection
• USB Headset with Noise Canceling
• Backup Power Source: Generator/UPS or access to an alternative location

Why Join Us? This is a long-term opportunity where you'll be part of an amazing team that will support and guide you in your work-from-home career.

For inquiries, email us at (Please note: Resumes sent directly to the HR email will not be entertained.)

Job Types: Full-time, Permanent

Experience:

• Medical and healthcare areas: 1 year (Required)

Work Location: Remote