Medical Biller

Medical Biller

Salary Range: $865 to $1,200 per month

Join a boutique fertility practice as a Medical Billing Specialist, taking ownership of insurance billing and accounts receivable follow-through from claim review through final resolution. You'll manage billing and insurance follow-up for a boutique fertility practice working primarily with commercial insurance plans. You'll work closely with insurance carriers and patients to resolve claims, denials, appeals, and outstanding balances while receiving training on fertility-specific billing processes and the practice's specialized EMR.

What You'll Do:

• Manage prior authorizations, claims, denials, appeals, and A/R follow-up with commercial insurance carriers.
• Submit and manage prior authorizations for fertility treatments and related services.
• Review prepared claims for accuracy, including modifiers, provider details, diagnosis codes, authorization information, and other required fields.
• Submit claims through the clearinghouse and monitor their status.
• Investigate denied or unpaid claims, correct errors, resubmit claims, and handle appeals or supporting documentation when needed.
• Track outstanding claims, follow up with insurance carriers, and manage insurance A/R through payment or final resolution.
• Review EOBs to determine whether balances are the responsibility of insurance or the patient.
• Contact patients via phone call regarding copays, deductibles, outstanding balances, insurance decisions, and self-pay amounts, and clearly explain what they owe.
• Support payment posting and reconciliation as needed.
• Handle approximately 5–30 patient encounters or claims per day depending on volume and complexity.

Who You'll Work With:

Be an integral part of a boutique fertility practice, working with management, front-office staff, insurance carriers, and patients to keep billing moving efficiently. You'll take ownership of claims after initial encounter information has been prepared and help ensure insurance balances are thoroughly followed through before responsibility is transferred to patients.

Who We're Looking For:

• Medical Insurance Experience: Experience in healthcare insurance billing or prior authorizations is required.
• Detail-Oriented: Able to catch claim errors, payer requirements, payment discrepancies, and maintain accurate billing and A/R records.
• Hard-Working: Willing to put in the effort to learn, follow up persistently, and keep working claims until they are resolved.
• Denials & Appeals: Able to investigate claim issues, identify corrections, work with insurance representatives, and follow denials or appeals through resolution.
• Organized: Keeps track of outstanding claims, insurance follow-ups, appeals, and deadlines without letting items fall through the cracks.
• Patient Communication: Comfortable explaining copays, deductibles, balances, and insurance decisions clearly and professionally by phone.
• Trainable: Willing and able to learn the full billing process, including how to work claims through insurance, handle denials, and learn fertility-specific billing rules, payer requirements, and the practice's EMR.
• Location: Must be located in the Philippines.

Why Join Us

• Impact: Take ownership of a critical billing function and help ensure insurance claims receive thorough, persistent follow-up through payment or final resolution.
• Culture: Join a collaborative practice that values accuracy, problem-solving, initiative, and a willingness to learn.
• Benefits:
• Enjoy preset salary growth and weekly salary payments.
• 100% work-from-home flexibility.

Work Details:

• Schedule: Mon - Fri 9:00 AM - 5:00 PM EST
• Employment Type: Full-time

How to Apply:

Click Apply to start your application. Come and make a difference in a growing healthcare practice!

We are an equal opportunity employer and value diversity at our company.