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:
- 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
- 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
- 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
- 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
- Maintain up-to-date knowledge of industry regulations and compliance
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)