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Medical Billing Associate

2 weeks ago

Makati City, National Capital Region, Philippines Private Advertiser Full time

Medical Billing Associate

The Medical Billing Associate will be responsible for managing the full revenue cycle process to ensure accurate and timely reimbursement for healthcare services. This role includes preparing and submitting claims, performing insurance verification, processing payment, resolving denials and maintaining billing accuracy based on US healthcare standards. The ideal candidate must have strong knowledge of CPT/HCPCS codes, ICD-10, fee schedules, modifiers and both in-network and out-of-network billing.

Duties & Responsibilities:

  • Submit clean claims to insurance payers (electronic and paper)
  • Verify patient insurance coverage, eligibility and benefits
  • Complete charge entry with accurate CPT. ICD-10, HCPCS codes and applicable modifier
  • Post payments, adjustments, write-offs and denials from EOB/ERA
  • Research and resolve claim denials, rejections and coding
  • Handle appeals and follow-up with insurance companies as needed
  • Maintain accurate patient billing records and documentation
  • Use fee schedules, POS codes and coding guidelines appropriately
  • Work on both in-network & out-of-network claims processing
  • Communicate with healthcare providers, insurance payers and internal teams for issue resolution
  • Ensure all billing activities comply with HIPPA and RCM standards

Qualifications

  • High school graduate (College Level/bachelor's degree holder) is a plus
  • 2-3 years of experience in Healthcare, Insurance or Medical Billing or US RCM (required)

  • Strong understanding of:

  • Claims processing & insurance verification

  • Charge entry & payment posting
  • CPT, HCPCS, ICD-10 coding
  • Modifiers & fee schedules
  • In-network & out-of-network billing
  • Excellent attention to detail and problem-solving skills
  • Good communication skills and ability to work independently
  • Familiarity with practice management systems and EMR tools is a plus