Healthcare Billing Specialist – ASC Billing

This is a fully remote position, open to applicants in Philippines.

📋 Description

• Oversee the complete billing process for Ambulatory Surgery Centers (ASC), which includes claims preparation, submission, tracking, follow-ups, addressing denials, appeals, and resolving reimbursement issues.

• Prepare, review, and submit claims for outpatient surgical procedures.

• Utilize ASC-specific CPT/HCPCS codes, modifiers, and billing guidelines.

• Confirm procedure details, modifiers, and supporting documentation.

• Navigate the billing requirements for Medicare, Medicaid, and commercial insurance.

• Investigate claims that have been rejected, denied, underpaid, or remain unpaid.

• Process corrected claims, reconsiderations, and appeals.

• Manage accounts receivable and follow up on pending ASC claims.

• Verify patient insurance eligibility, coverage, and benefits.

• Collaborate with insurance representatives and internal teams.

• Achieve a daily productivity goal of 45 claim follow-ups.

• Upload, track, organize, and maintain Explanation of Benefits (EOBs).

• Ensure accurate claims records are maintained.

• Assist with home health billing and overall revenue cycle management.

• Review and process Notices of Admission (NOAs).

• Use ALORA for billing, documentation, and claim tracking when applicable.

• Generate billing reports, spreadsheets, claims trackers, and documentation.

• Provide administrative, executive, and operational assistance.

• Facilitate workflow enhancements.

• Handle inbound and outbound calls utilizing Nextiva VoIP.

• Address patient inquiries and provide receptionist-level assistance.

• Communicate effectively with patients, insurance representatives, and internal staff.

• Uphold patient confidentiality and adhere to HIPAA regulations.

⛳️ Requirements

• Demonstrated hands-on experience in U.S. Ambulatory Surgery Center (ASC) billing.

• Strong grasp of ASC billing workflows, outpatient surgical claims, and revenue cycle management.

• Experience in preparing, submitting, tracking, and following up on ASC claims.

• Proficient knowledge of CPT, HCPCS, ICD-10, and ASC-related modifiers.

• Familiarity with Medicare and commercial insurance billing standards for outpatient surgical procedures.

• Experience in managing denied, rejected, underpaid, and unpaid medical claims.

• Practical experience with accounts receivable, insurance follow-ups, claim corrections, and appeals.

• Ability to recognize billing discrepancies, coding errors, missing documentation, and reimbursement challenges.

• Proficient in verifying insurance eligibility, coverage, and benefits.

• Familiarity with EOBs, payment discrepancies, and claims tracking processes.

• Capability to maintain precise records and achieve daily productivity goals.

• Strong understanding of payer-specific billing requirements and reimbursement guidelines.

• Excellent attention to detail, analytical thinking, and problem-solving capabilities.

• Strong organizational skills and ability to multitask effectively.

• Exceptional written and verbal communication skills in English.

• Ability to work independently, manage conflicting priorities, and adapt to changing workflows.

• Knowledge of HIPAA compliance and patient confidentiality standards.

• Proficient in speaking and writing clear, professional English.

• Must possess relevant hands-on experience in U.S. medical billing, especially ASC billing.

• Required to submit an NBI Clearance and/or Local Police Clearance prior to onboarding.

• Must be available for video meetings with the camera on when necessary.

• Must be available to work full-time, Monday through Friday, from 9:00 AM to 6:00 PM Eastern Time.

• Reliable laptop or desktop computer is mandatory.

• Stable high-speed internet connection with a minimum of 25 Mbps is required.

• Noise-canceling headset is necessary.

• A working webcam is essential.

• A quiet and professional work environment is expected.

🏝️ Benefits

• Dedicated HR & Contractor Support Team.

• Premium VPN Access (Optional).

• HIPAA & Cybersecurity Training + Certification (Provided).

• Top 1% VA Performance Training.

• Client-Approved U.S. Holidays.

• Client-Approved Paid or Unpaid Time Off.

• Access to Tools & Resources.

• Optional Performance-Based Incentives.

• Optional contractor perks and client-approved allowances.