Eastwood Libis, QC, PH

Medical Billing Specialist-Payment Posting

Summary:

The Medical Billing Specialist-Payment Posting is responsible for ensuring the timely and accurate payment of medical services rendered to our client's patients. This includes charge entry, collecting payments from insurance companies, and providing exceptional customer service.

Job Details:

  • Medical Billing Specialist- Payment Posting
  • Work from home
  • Monday to Friday | 8:00 PM-5:00 AM Philippine Time
  • *Candidates who are residing in the metro area are preferred.

Responsibilities:

  • Process payments received and create batches for posting.
  • Identify underpayments and prepare appeals documents.
  • Code claims accordingly with CPT and ICD 10s codes.
  • Submit claims to clearinghouses and update or review claims corrections.
  • Communicate with patients, providers, and payers to check eligibility, pre-certify, or follow up on claims and appeals
  • Perform other duties as assigned by management

Qualifications:

  • At least 3 years of experience in US Healthcare.
  • Knowledge of medical billing codes, including CPT and HCPCS coding, 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.

Medical Billing Specialist – Collections

Summary:

The primary responsibility of the Medical Billing Specialist – Collections is to assist our clients in collecting payments from the insurance companies for their medical services rendered to their patients. This includes charge entry and providing exceptional customer service.

Job Details:

Medical Billing Specialist – Collections

Work from home

Monday to Friday | 8:00 PM to 5:00 AM (Manila)

*Following US Holidays

Responsibilities:

• Review/Analyze explanation of benefits (EOB), Remittance Advice, and Denials from Payers to drive resolution for account receivables.

• Preparation and analysis of aging reports.

• Use all channels available to resolve and collect account receivables with payers which includes but is not limited to utilizing payer portals and outbound calls to the provider desk.

• Review or update claims corrections and uploads required documents in our clearinghouse portals.

• Identifying underpayments and preparing documents for appeals

• Creating batches and post-received payments.

• Code claims accordingly with CPT and ICD 10s codes.

• Perform other duties assigned by the management.

• Post charges to create a claim and submit it to our clearinghouses.

• Contact patients, providers, and payers to check eligibility, pre-cert, or follow up on claims/appeals.

• Ability to work well independently and communicate efficiently and respectfully with patients and insurance representatives.

• Identify billing errors and denials, by understanding the problem and resubmit corrected claims or take other appropriate action to resolution.

Qualifications:

• At least 3 years of experience in Medical Billing and Collections.

• Knowledge of medical billing codes, including CPT and HCPCS coding, 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.

• Previous experience in Orthopedic, Spine Surgery and Pain Management Specialty a plus.


Medical Billing Specialist (eCW)

Position Summary:

The Medical Billing Specialist will be responsible for managing and processing medical claims, ensuring accuracy, and maintaining compliance with relevant regulations. This role requires expertise in using Medisoft and/or eCW for payment posting, as well as a strong understanding of out-of-network health Insurance, Workers' Compensation, and Personal Injury Protection (PIP) claims in the U.S. The ideal candidate will be detail-oriented, capable of working in a fast-paced environment, and possess strong analytical skills.

Job Details:

  • Medical Billing Specialist
  • Work from home
  • Monday to Friday| 8 PM to 5 AM Manila Time

Responsibilities:

  1. Payment Posting:
    • Accurately post payments using Medisoft and/or eCW
    • Reconcile posted payments with Explanation of Payments
    • Identify and correct any discrepancies in payment posting
  2. Claims Management:
    • Process and manage Out of Network Health Insurance, Workers Compensation, and PIP claims
    • Ensure timely and accurate submission of claims
    • Follow up on unpaid or denied claims to ensure maximum revenue realization
  3. Data Analysis and Reporting:
    • Analyze billing data to identify trends, errors, and opportunities for improvement
    • Prepare and submit reports on billing activities and outcomes
    • Collaborate with the management team to develop strategies for optimizing billing processes
  4. Compliance and Documentation:
    • Maintain up-to-date knowledge of industry regulations and compliance
      requirements
    • Ensure all billing activities are compliant with relevant laws and guidelines
    • Accurately document all billing and claims activities

Qualifications:

  • Proven experience using Medisoft and/or eCW (eClinicalWorks) for payment posting
  • Strong knowledge of Out of Network Health Insurance, Workers Compensation, and PIP claims in the U.S
  • Exceptional attention to detail and accuracy
  • Ability to work efficiently in a fast-paced environment
  • Strong analytical and problem-solving skills
  • Ability to work independently and as part of a team
  • Proficiency in Microsoft Office Suite (Excel, Word, Outlook)