Back Office Support

Medical Billing Specialist - Charge Entry

Job Summary:

We are seeking a Medical Billing Specialist – Charge Entry who has an extensive experience in data entry for medical billing, coding, and charges in the US Healthcare Industry. You will be responsible for carefully reviewing various types of Data given by clients. You will be working with data from demographics, patient billing, and insurance information gathering. Aside from this, you will also be doing other tasks related to billing such as collecting payments from insurance companies, payment posting, and providing exceptional customer service.

Job Details:

  • Medical Billing Specialist – Charge Entry
  • Work from home
  • Monday to Friday | 8:00 PM to 5:00 AM (Manila)
  • *Following US Holidays

Responsibilities:

  • Prompt response to requests for information, both internally and externally
  • Timely and accurately enter charges from super bills and demographic reports.
  • Expert ability to add specific data such as modifiers, payer specific information, including authorization criteria, CPT and ICD-10 code and dates.
  • Processing and discrepancy reconciliation and closing of charge batches across all systems.
  • Ability to successfully track and follow up on information requests to and from the practice.
  • Other duties as assigned.

Qualifications:

  • At least 2 years’ Experience in a similar role.
  • Effective oral and written communication skills
  • Knowledge of medical billing codes, including CPT, claims modifiers, and ICD-10 diagnosis coding.
  • Familiarity with Revenue Cycle Management (RCM) systems, Practice Management Systems (PMS), and tools.
  • Understanding of different types of insurance coverages and claims, including Health, Workers' Comp, and Auto
  • Ability to read and interpret EOBs (Explanation of Benefits)
  • Experience with coordinating with insurance companies.
  • Strong adaptability and ability to learn quickly.
  • Proven efficiency and punctuality in completing tasks.

by Carl Trinidad

Medical Billing Specialist - AR and Charge Entry - WFH (AMH)

Position Summary:

We are looking for an experienced Medical Billing Specialist - AR and Charge Entry to join our healthcare team. This role requires a minimum of 3 years of experience in Accounts Receivable (AR) and proficiency in English due to frequent interactions with patients. The ideal candidate will have extensive knowledge of Practice Management (PM) and Electronic Medical Record (EMR) systems. As a vital member of our team, you will ensure accurate and efficient medical billing processes without management responsibilities.

Job Details:

  • Work from home
  • Monday to Friday | 9 PM to 6 AM Manila Time
  • *Following US Holidays

Responsibilities:

  • Customer Support: Provide excellent customer service by addressing patient and healthcare provider inquiries related to medical billing and insurance claims. Explain billing information clearly and empathetically.
  • Billing Inquiries: Assist patients with questions regarding billing statements, insurance coverage, and payment options. Translate complex billing information into understandable terms.
  • Claims Processing: Review and process insurance claims, ensuring accuracy and completeness of all necessary information. Rectify any discrepancies or errors in submissions.
  • Payment Verification: Verify insurance eligibility, benefits, and authorizations. Confirm the accuracy of patient information and insurance details for claims processing.
  • Dispute Resolution: Address and resolve billing disputes, discrepancies, and denied claims. Collaborate with insurance companies and healthcare providers for efficient problem-solving.
  • Documentation: Maintain detailed records of customer interactions, billing inquiries, and resolutions. Ensure proper documentation and filing of all billing and insurance information.

Qualifications:

  • Minimum of 3 years experience in medical billing, specifically in Accounts Receivable.
  • Proficiency in English with excellent verbal and written communication skills.
  • Extensive experience with PM/EMR systems.
  • Strong understanding of medical billing processes, insurance claims, and payment verification.
  • Ability to explain complex billing concepts clearly and empathetically to patients.
  • Proven track record in dispute resolution and claims processing.
  • Exceptional organizational skills and attention to detail for accurate documentation and record-keeping.

by Carl Trinidad

Medical Billing Specialist - AR

Position Summary:

The Medical Billing Specialist - AR will play a vital role in our financial team with the primary responsibility of handling all aspects of claims management, from investigation to resolution. This involves reviewing and analyzing the status of claims, navigating various online portals, and regularly communicating with payers. The position also requires a proactive approach towards the investigation and analysis of claim denials, finding effective solutions to ensure their payment, and consistently following up on any outstanding claims. The Accounts Receivable Specialist will report directly to the Accounts Receivable Supervisor/Manager and contribute to the effective and efficient operation of our financial management system.

Job Details:

  • Medical Billing Specialist - AR
  • Work from home
  • Monday to Friday | 10:00 PM to 7:00 AM Manila time
    • Following Philippine Holidays

Responsibilities:

  • Navigate Different Online Portals: Regularly access various online systems to check the status of claims, ensuring they are processed correctly and in a timely manner.
  • Communicate with Payers: Contact payer hotlines for inquiries, clarifications, and the status of claims. Display professionalism and efficiency in all interactions to maintain positive relationships.
  • Investigate Claim Denials: Proactively investigate the reasons behind claim denials, analyze the information gathered, and develop effective solutions to ensure claim payments.
  • Manage Claim Adjustments: Resubmit claims, request reprocessing, send corrected claims, and/or create appeals as needed, based on analysis and investigation results.
  • Follow Up on Outstanding Claims: Diligently and promptly follow up on any open and unpaid claim until the Accounts Receivable list is cleared up, preventing untimely resubmission or appeal.
  • Report Regularly: Provide daily reports to the Accounts Receivable Supervisor/Manager about completed tasks and any pending issues, ensuring clear and concise communication about any updates or issues that require attention.
  • Maintain the Accounts Receivable System: Regularly update the Accounts Receivable system with clear, comprehensive notes to track progress and facilitate efficient claim management.

Qualifications:

  • At least 3 years’ experience in an accounts receivable role, with a focus on healthcare claims management.
  • Excellent ability to navigate and use various online systems and portals.
  • Strong communication skills, both verbal and written, for effective liaison with payers and internal stakeholders.
  • Proven analytical and problem-solving skills, with the ability to analyze claim denials and devise effective resolutions.
  • Attention to detail and high levels of accuracy in all tasks.
  • Ability to work effectively under pressure and manage multiple priorities.
  • Proficient in using accounts receivable software and other standard office software such as Microsoft Office.

by Carl Trinidad