Eastwood Libis, QC, PH

Medical Coder

Summary:

We are currently seeking a highly skilled and motivated Medical Coder to join our growing team. The successful candidate will be responsible for translating medical documentation into standardized codes for billing purposes, ensuring accuracy and compliance with regulatory guidelines. This position requires a strong understanding of medical terminology, anatomy, and coding principles.

What’s in it for you?

  • Health Insurance (HMO)
  • Competitive Salary
  • Expanded maternity leave up to 120 days
  • Allowances
  • Paid Time offs (Vacation Leaves Are Convertible to cash if unused)
  • Companywide events
  • Fun & Relaxed environment

Job Details:

  • Medical Coder
  • Work from home
  • Monday to Friday | 11:30 PM to 8:30 AM (Manila time)
  • *Following US Holidays

Responsibilities:

  • Review and analyze medical records, physician notes, and other relevant documents to accurately assign appropriate codes for diagnoses and procedures.
  • Ensure accurate coding of services for assigned specialties.
  • Maintain up-to-date knowledge of ICD-10-CM, CPT, and HCPCS coding guidelines and industry changes.
  • Collaborate with billing and insurance teams to address coding discrepancies and resolve any issues that may arise.
  • Conduct internal audits to ensure compliance with federal, state, and payer-specific regulations.
  • Provide support and guidance to medical staff and colleagues regarding proper documentation and coding practices.
  • Participate in continuing education programs and maintain professional certifications.
  • Maintain strict confidentiality and adhere to all HIPAA guidelines and regulations.

Qualifications:

  • At least 2 years of experience in medical coding, with a focus on specializing in Infusion, Radiation, and Medical Oncology.
  • Certification as a Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent through a recognized coding organization (e.g., AAPC, AHIMA).
  • Proficiency in ICD-10-CM, CPT, and HCPCS coding systems and guidelines.
  • Strong knowledge of medical terminology, anatomy, and physiology.
  • EPIC/Athena experience will be a plus.
  • Excellent attention to detail and the ability to accurately interpret complex medical information.
  • Strong analytical, problem-solving, and decision-making skills.
  • Excellent communication skills. He/she will deal with Doctors in providing education and audits to our value-based program.
  • High level of integrity and professionalism, with the ability to maintain strict confidentiality.
  • Strong organizational skills, with the ability to manage multiple tasks and priorities in a fast-paced environment.
  • Proficient in Microsoft Office applications (Word, Excel, Outlook) and the ability to adapt to new software systems quickly.

by Carl Trinidad

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.

by Carl Trinidad

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.

by Carl Trinidad