Rate: 40,000 - 50,000 PHP
Schedule: 8 HRS, plus 1 HR non-paid break
We are looking for an experienced Medical Coder & Biller who can accurately read and interpret medical records, process U.S. healthcare claims, and review medical bills against provider estimates, approved procedures, and final charges. A graduate of a medical-related course is preferred.
Key Responsibilities- Request, review, and validate medical bills and records from healthcare providers.
- Read and interpret medical records, including diagnoses, procedures, treatments, and clinical documentation.
- Review provider estimates and approved procedures against final medical bills.
- Identify billing discrepancies, coding errors, missing documentation, and inconsistencies.
- Assign, verify, and apply appropriate ICD-10, CPT, and HCPCS codes.
- Prepare and submit accurate claims to private insurers, Medicare, and Medicaid.
- Verify patient eligibility, insurance coverage, benefits, and authorization requirements.
- Monitor and follow up on unpaid, delayed, denied, or rejected claims.
- Investigate claim denials, identify the root cause, make necessary corrections, and resubmit claims.
- Post payments, adjustments, and denials accurately in the billing system.
- Communicate with insurance companies and healthcare providers to resolve billing and claims issues.
- Maintain accurate, complete, and HIPAA-compliant medical billing and claims documentation.
- Prepare claim status, billing, accounts receivable, and collection reports.
Qualifications- Proven experience in U.S. medical coding, medical billing, claims processing, or revenue cycle management (RCM).
- Strong ability to read, interpret, and understand medical records and clinical documentation.
- Experience reviewing and verifying medical bills, provider estimates, authorizations, and final charges.
- Ability to identify discrepancies between medical records, approved procedures, and billed services.
- Strong knowledge of medical terminology, diagnoses, procedures, and treatment workflows.
- Proficiency in ICD-10, CPT, and HCPCS coding.
- Knowledge of U.S. healthcare insurance, claims processing, and payer requirements.
- Familiarity with HIPAA regulations and handling confidential patient information.
- Strong attention to detail, analytical, organizational, and problem-solving skills.
- Graduate of a medical-related course is preferred.
- Experience with U.S. healthcare accounts, billing software, EHR/EMR, or practice management systems is an advantage.
