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Virtual Assistant: Medical Biller

2 weeks ago

Manila, National Capital Region, Philippines Private Advertiser Full time ₱180,000 - ₱360,000 per year
Medical Accounts Receivable (A/R) Specialist – Job Description
Position Summary

The Medical Accounts Receivable Specialist is responsible for managing and resolving outstanding patient and insurance balances. This role ensures timely reimbursement by following up on denied, unpaid, or underpaid claims, verifying insurance details, and working closely with billing and coding teams to reduce aging A/R and improve cash flow.


Key Responsibilities
1. Insurance Follow-Up
  • Review outstanding insurance claims in all aging categories (0–30, 31–60, 61–90, 90+ days).
  • Contact insurance companies via phone, portals, or clearinghouses to check claim status.
  • Resolve issues such as missing documentation, incorrect coding, prior authorization problems, or coordination of benefits.
2. Denial Management
  • Identify reasons for claim denials and take corrective action.
  • Submit corrected claims, appeals, or required medical documentation.
  • Track patterns/trends and report them to the billing manager.
3. Patient A/R Management
  • Review patient balances and send statements or payment reminders.
  • Set up payment plans when appropriate.
  • Explain insurance benefits, deductibles, and patient responsibilities.
4. Payment Posting & Reconciliation
  • Review Explanation of Benefits (EOB) / Electronic Remittance Advice (ERA).
  • Post insurance and patient payments accurately.
  • Reconcile account balances and make necessary adjustments.
5. Reporting & Documentation
  • Maintain detailed notes of all actions taken on each account.
  • Prepare weekly or monthly A/R aging reports.
  • Meet assigned productivity and collection goals.
6. Compliance
  • Follow HIPAA and all confidentiality regulations.
  • Ensure compliance with payer policies and billing guidelines.

Basic Requirements
Education
  • High school diploma or equivalent (required).
  • Associate's degree in healthcare administration, business, or related field (preferred).
Experience
  • 3–6 years of experience in medical billing, accounts receivable, or revenue cycle management.
  • Familiarity with insurance plans: Medicare, Medicaid, commercial payers.
  • Experience working in an EMR/EHR (eClinicalWorks, Epic, Athena, NextGen, Kareo, etc.).
Skills
  • Strong understanding of CPT, ICD-10, and HCPCS coding basics.
  • Knowledge of claim processes, EOB/ERA interpretation, and payer guidelines.
  • Excellent communication (verbal and written).
  • Ability to manage multiple accounts and meet deadlines.
  • Problem-solving and analytical skills.
  • High attention to detail and accuracy.
Technical Skills
  • Proficiency in medical billing software and clearinghouses.
  • Basic Excel/Google Sheets for reporting (filters, pivot tables preferred).
  • Comfortable with payer portals.