Medicaid Billing Specialist

We're Hiring: Medical Biller (Initial Claims Submission - RCM Healthcare Process)!

The Billing Specialist is responsible for ensuring the accurate and timely submission of claims to payers, maintaining compliance with industry standards, and ensuring billing accuracy. This role focuses on precise claim preparation, attention to detail, and proper documentation to minimize errors and maximize clean claim rates. The ideal candidate will have a strong understanding of medical billing practices and payer requirements.

Location:Pasig, Philippines
Work Mode:Flexible office & remote (HYBRID)
Role:Medical Biller (Initial Claims Submission - RCM Healthcare Process)

What You'll Do:

• Prepare and submit accurate claims in accordance with payer guidelines and customer billing cycles
• Ensure all claim details are complete and error-free, including coding, provider information, and service dates
• Review claims for accuracy and compliance with Medicaid, Medicare, VA, and payer regulations
• Verify correct taxonomy codes, modifiers, and billing procedures to prevent rejections
• Maintain a high clean-claims submission rate by thoroughly reviewing and validating claim information before submission
• Ensure compliance with industry regulations, payer policies, and internal billing procedures
• Maintain accurate and organized billing records and documentation
• Identify and report billing trends, potential errors, and areas for process improvement
• Collaborate with internal teams to standardize billing practices and enhance efficiency
• Support billing audits and internal quality control measures
• Other duties as assigned
  
  

What We're Looking For:

• Experience working in billing and health care preferred
• Hands-on experience in initial claims submission or creating clean claims from scratch
• Worked with payors such as Medicaid, Veterans Affair, etc.
• Customer service experience preferred
• Excellent follow-up, time management, and communication skills required
• Proficiency in MS Office Suite (Outlook, Word, Excel) is required
• Familiar with EPIC system, Availity portal
• Back-office support & Email customer invoicing
• Amenable in working in a graveyard shift and working onsite/hybrid in Ortigas, Pasig City.
  
  

Ready to make an impact Apply now and let's grow together!