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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 – 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.
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.