Medical Billing Specialist

2 weeks ago

Eastwood Quezon City, Philippines Sourcefit Full time ₱550,000 - ₱850,000 per year

Position Summary:

The Medical Billing Specialist - Collection is a key role within our healthcare team. This position is accountable for monitoring the status of medical claims, thoroughly investigating rejections and denials, and diligently documenting related account activities. The Medical Biller is tasked with the critical responsibility of posting adjustments and managing collections for a diverse range of payers, including Medicare, Medicaid, Medicaid Managed Care, commercial insurance, and Workers' Compensation. The role requires a deep understanding of various eligibility requirements and payment methodologies, as well as a keen ability to record contractual adjustments in compliance with government regulations and payer contracts.

Job Details:

Medical Billing Specialist - Collection

Permanent work from home

Mondays to Fridays | Night Shift

*Following US Holidays

Responsibilities:

· Monitor the status of medical claims to ensure prompt and accurate payment.

· Research and resolve claim rejections and denials, implementing measures to prevent future occurrences.

· Document all account activities accurately and in a timely manner.

· Post payments and correctly record adjustments as necessary.

· Understand and apply Medicare, Medicaid, and commercial insurance eligibility requirements and payment methodologies.

· Exhibit proficiency with billing systems and leverage all functionality to ensure the most efficient processing of claims.

· Maintain up-to-date knowledge of changes in billing and coding guidelines, payer contracts, and government regulations.

· Collaborate with team members and providers, fostering a positive and productive work environment.

· Willing to learn claims review and submission, and pre-visit eligibility and benefits verification to backfill other staff during absences.

Qualifications:

· At least 2 years of strong background in end-to-end revenue cycle processes, including eligibility verification, charge review, claims submission, and denial management, and collections is required.

· Experience in DME and using Apero is preferred but not required.

· Candidates must demonstrate an ability to work collaboratively with team members and healthcare providers.

· Candidates must be able to function in a fast-paced work environment and handle occasional periods of above-average pressure.

· Excellent customer service skills are necessary, as the role involves interacting with various stakeholders, including patients, insurance companies, and healthcare providers.

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