Hospital Billing Representative | Permanent WFH

We are seeking an experienced Hospital Billing Representative to join our Patient Financial Services and Revenue Cycle team. This role is responsible for managing insurance claim follow-up, resolving billing issues, and reducing outstanding accounts receivable to support timely and accurate reimbursement.

The ideal candidate has hands-on experience with hospital or medical billing, insurance collections, denial management, and A/R follow-up. Strong attention to detail, analytical thinking, and knowledge of payer processes are essential for success in this role.

Key Responsibilities

• Perform timely follow-up on outstanding hospital and insurance claims to secure reimbursement
• Contact Medicare, Medicaid, and commercial insurance payers to verify claim status and resolve payment issues
• Review denied and underpaid claims, identify root causes, and determine appropriate resolution
• Prepare and submit accurate claim appeals with required supporting documentation
• Research payer guidelines and requirements to resolve billing and reimbursement issues
• Review A/R aging reports and prioritize accounts based on balance, age, and urgency
• Identify and correct claim errors in coordination with billing, coding, and other revenue cycle teams
• Maintain detailed and accurate documentation of all account activity and payer communications
• Monitor assigned accounts through resolution and ensure appropriate follow-up
• Maintain compliance with HIPAA, payer requirements, and internal billing policies
• Identify recurring billing and denial issues and contribute to process improvement initiatives
• Perform other duties as assigned within the Patient Financial Services team
  
  

Qualifications

• 2+ years of experience in hospital billing, hospital collections, or medical billing/collections
• Familiarity with CPT, ICD-10, and HCPCS coding systems
• Experience working with hospital billing systems, EHRs, or revenue cycle platforms
• Strong understanding of payer requirements and denial resolution strategies
• Experience handling high-volume A/R follow-up and insurance collections
• Knowledge of hospital revenue cycle workflows and reimbursement processes
• High school diploma or equivalent
• Hands-on experience with insurance claims follow-up and denial management
• Working knowledge of Medicare, Medicaid, and commercial insurance processes
• Experience managing medical A/R and interpreting aging reports
• Strong attention to detail and ability to research and resolve complex billing issues
• Excellent written and verbal communication skills
• Ability to manage multiple accounts while meeting productivity and quality expectations
• Amenable to work during US hours
• Must be willing to undergo a background check as part of the hiring process.
  
  

Perks

• Permanent Work From Home
• Leave Credits
• Monetary Allowance
• Annual Bonus
• Weekly Paychecks
• Fixed Weekends Off
• Thriving Company Culture with Complete Autonomy
• Exclusive Specialized Training Programs
• Unlock Your Potential with a Highly Competitive Salary
  
  

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Who are we

BizForce is one of the fastest-growing global outsourcing companies in the world, founded in the US in Tucson, Arizona and is now operational in PH!

Our Commitment to delivering high-quality results for our clients and the only way to do that is ensuring a rewarding, respectful and productive experience for our employees. We hold the same values for both our customers and our employees.