Schedule: 10:00pm - 7:00am PH time (8:00am - 5pm MDT)
Rate: Php45,000.00/monthly
Key Responsibilities
Medical Billing & Claims Management
- Billing Preparation & Submission
- Prepare, review, and submit accurate medical claims to insurance companies (private, Medicare, Medicaid) using ICD-10, CPT, and HCPCS codes.
- Insurance Verification
- Verify patient insurance coverage, eligibility, and benefits to ensure accurate billing and prevent claim denials.
Claims Tracking & Follow-Up
- Monitor submitted claims, track statuses, and follow up on unpaid, denied, or rejected claims to ensure timely reimbursement.
- Denial Management
- Identify reasons for claim denials, correct errors, gather missing documentation, and resubmit claims as needed.
Payment Posting
- Accurately post payments, adjustments, and rejections to patient accounts while maintaining clean financial records.
Compliance & Documentation
- Ensure all billing activities comply with U.S. healthcare regulations, including HIPAA, payer-specific guidelines, and coding standards.
Reporting
- Generate billing, collection, and claims-tracking reports to help improve revenue cycle efficiency.
Qualifications
- Minimum of four (4) years of proven experience in U.S. Medical Billing, Claims Processing, or Revenue Cycle Management.
- Medical Knowledge
- Strong understanding of medical terminology, common diagnoses, procedures, and treatment workflows (no clinical background required).
- U.S. Healthcare & Billing Experience
- Proven experience in U.S. medical billing, claims processing, or revenue cycle management.
- Must be proficient with ICD-10, CPT, and HCPCS coding and familiar with HIPAA regulations.
- Billing Systems Expertise
- Hands-on experience using medical billing software, EMR/EHR systems, and insurance portals.
- Claims & Coding Accuracy
- High attention to detail with the ability to identify coding errors, documentation gaps, and inconsistencies in claims.
- Problem-Solving & Denial Management
- Ability to research, analyze, and resolve denied or unpaid claims and handle follow-ups with insurers.
Soft Skills
- Organized, analytical, and able to manage high volumes of data efficiently.
- Professional and confident communicating with insurance representatives, healthcare providers, and internal teams.
- Communication Skills
- Excellent written and verbal English communication skills, especially in explaining billing issues and coordinating claim resolutions.
