Eastwood Libis, QC, PH

Medical Billing Specialist – AR/Collection

Position Summary:

The Medical Billing Specialist – AR/Collection is responsible for researching rejections/denials, correcting/rebilling claims as necessary, and documenting all related account activities. The A/R specialist must possess critical thinking skills and be proactive when working claims to determine the appropriate method to get the claims billed out and paid. In addition, the candidate must be familiar with reading an EOB, using the insurance portals and be comfortable with calling insurance companies when necessary to obtain additional information necessary. Experience with Athena is preferred but not mandatory.

Job Details:

  • Permanent work from home
  • Monday to Friday | 11 PM to 7 AM Manila time
  • Following US Holidays

Responsibilities:

  • Monitor the status of medical claims to ensure prompt and accurate payment.
  • Research and resolve claim rejections and denials, implementing measures to prevent future occurrences.
  • Document all account activities accurately and in a timely manner.
  • Post adjustments and manage collections from various types of payers.
  • Understand and apply Medicare, Medicaid, and commercial insurance eligibility requirements and payment methodologies.
  • Correctly record contractual adjustments based on payer contracts and government regulations.
  • Exhibit proficiency with billing systems and leverage all functionality to ensure the most efficient processing of claims.
  • Maintain up-to-date knowledge of changes in billing and coding guidelines, payer contracts, and government regulations.
  • Collaborate with team members and providers, fostering a positive and productive work environment.

Qualifications:

  • At least 2 years of experience in medical billing and collections is required.
  • Experience in using Athena is preferred.
  • Candidates must demonstrate an ability to work collaboratively with team members and healthcare providers.
  • Candidates must be able to function in a fast-paced work environment and handle occasional periods of above-average pressure.
  • Excellent customer service skills are necessary, as the role involves interacting with various stakeholders, including patients, insurance companies, and healthcare providers.

by Carl Trinidad

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 (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)

by Carl Trinidad