Medical Billing Specialist

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

📋 Description

• Oversee collection processes for TDD services.

• Review contracts and reimbursement details.

• Manage denial and appeal processes.

• Address billing-related issues with insurance companies or other liable parties.

• Follow up on submitted invoices to guarantee prompt payment, escalating issues when necessary.

• Assess payments and denials for accuracy and apply them appropriately.

• Identify write-offs for bad debt and make accounts receivable adjustments as per established policies.

• Detect, investigate, and rectify overpayments and duplicate payments.

• Process refund requests in line with policies and procedures.

• Acquire patient or insurance information necessary for claim payments through collaboration with other departments.

• Ensure collection operations adhere to department protocols and comply with federal, state, and payer regulations and guidelines.

• Make calls to troubleshoot payment discrepancies and implement resolutions.

• Document calls, including phone numbers, individuals spoken to, and call specifics.

• Optimize claim reimbursement.

• Resolve issues causing denials within 5 days of receipt.

• Uphold patient confidentiality and comply with HIPAA guidelines and regulations.

• Utilize knowledge of NDC numbers, metric quantities, infusion supplies, insurance plans, medical terminology, billing procedures, government regulations, and medical codes.

• Share expertise with team members and collaborate effectively.

• Perform other job-related responsibilities as assigned.

⛳️ Requirements

• A high school diploma or equivalent general education degree (GED).

• Minimum of 3 years of experience in medical billing and collections.

• Experience in Home Infusion, hospital, or chemotherapy environments is mandatory.

• Proficiency in calculating drug units.

• Background in Intrathecal Pain Management is considered an advantage.

• Ability to identify, assess, and exercise sound judgment in resolving complex situations while complying with laws and regulations.

• Exceptional verbal and written communication skills, with an aptitude for building relationships and negotiating with various internal and external stakeholders.

• Strong work ethic and personal attributes of integrity and credibility.

• Self-motivated, detail-oriented, conscientious, organized, and capable of follow-through.

• Ability to methodically handle problems involving multiple variables relevant to the position.

• Capacity to tolerate frequent interruptions and distractions from staff and other internal support teams.

• Proficient in Microsoft Office Suite, including Outlook, Word, and Excel.

• Availability to work Monday to Friday, from 9 PM to 6 AM Manila Time.

🏝️ Benefits

• Work-from-home opportunity.

• Monday to Friday work schedule.

• Observance of US Holidays and Philippine Regular Holidays.