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MicroSourcing

Medical Biller - Revenue Cycle Specialist

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  • Posted 15 hours ago
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Job Description

Discover your 100% YOU with MicroSourcing!

Position: Medical Biller

Work setup & shift: Onsite and Night shift

Location: 1880 Building, Eastwood, Libis

Why join MicroSourcing

You'll Have

  • Competitive Rewards: Enjoy above-market compensation, healthcare coverage on day one, plus one or more dependents, paid time-off with cash conversion, group life insurance, and performance bonuses
  • A Collaborative Spirit: Contribute to a positive and engaging work environment by participating in company-sponsored events and activities.
  • Work-Life Harmony: Enjoy the balance between work and life that suits you with flexible work arrangements.
  • Career Growth: Take advantage of opportunities for continuous learning and career advancement.
  • Inclusive Teamwork: Be part of a team that celebrates diversity and fosters an inclusive culture.

Your Role:

Position Summary

The Medical Biller (Revenue Cycle Specialist) with deep expertise in full-cycle billing, payer guidelines, denial management, and claims resolution. This individual plays a critical role in optimizing revenue capture, reducing AR, ensuring coding accuracy, and maintaining the financial health of our multi-specialty medical organization.

The ideal candidate is proactive, analytical, and confident in navigating commercial, Medicare, Medicare Advantage, Medicaid, and specialty payer environments. We are looking for a true RCM professional who can drive performance, anticipate trends, and uphold compliance while delivering exceptional internal and external customer service.

Key Responsibilities2. Denial Management & Appeals3. Accounts Receivable Management4. Coding Validation & Documentation Support5. Patient Account Resolution6. Reporting & Performance Tracking

  • Full Revenue Cycle Ownership
  • Process claims from charge entry through payment posting, including corrections and appeals.
  • Ensure timely submission of clean claims across all payers and specialties.
  • Monitor claims status daily; resolve holds, rejections, and payer edits promptly.
  • Maintain a high first-pass acceptance rate for all claims.
  • Investigate and resolve denials with strong understanding of payer policies.
  • Draft clear, compelling appeals supported by documentation and correct coding rules.
  • Identify root causes of recurring denials and propose preventative solutions.
  • Track denial trends and communicate action steps to coding, providers, and leadership.
  • Maintain AR days within benchmarks set by leadership.
  • Work aged AR efficiently with prioritization of high-value and time-sensitive claims.
  • Conduct routine AR audits to ensure accurate balances and payer compliance.
  • Communicate effectively with payers to resolve pending issues and secure payment.
  • Collaborate with coding team to ensure claims reflect accurate ICD-10, CPT, and HCPCS assignments.
  • Escalate documentation concerns to providers or coders with clear recommendations.
  • Stay current on payer-specific policies, CCI edits, bundling rules, and CMS updates.
  • Provide feedback to clinical teams on documentation patterns that affect reimbursement.
  • Assist with patient billing questions, balances, and payment plans.
  • Work alongside front desk and call center to ensure insurance verification accuracy and prevent downstream billing issues.
  • Maintain professionalism and empathy when interacting with patients.
  • Prepare weekly and monthly RCM performance reports as needed.
  • Track claim status, denial patterns, AR aging, and reimbursement fluctuations.
  • Provide insights and recommendations to leadership for improvement opportunities.

About MicroSourcing

With over 9,000 professionals across 13 delivery centers, MicroSourcing is the pioneer and largest offshore provider of managed services in the Philippines.

Our commitment to 100% YOU

MicroSourcing firmly believes that our company's strength lies in our people's diversity and talent. We are proud to foster an inclusive culture that embraces individuals of all races, genders, ethnicities, abilities, and backgrounds. We provide space for everyone, embracing different perspectives, and making room for opportunities for each individual to thrive.

At MicroSourcing, equality is not merely a slogan it's our commitment. Our way of life. Here, we don't just accept your unique authentic self - we celebrate it, valuing every individual's contribution to our collective success and growth. Join us in celebrating YOU and your 100%!

For more information, visit https://www.microsourcing.com/

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About Company

Job ID: 137615445