Medical Claims Billing Specialist

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

📋 Description

• Accurately and efficiently submit medical claims to insurance payers.

• Review, track, and follow up on claims that have been denied, rejected, unpaid, or are stale.

• Collaborate directly with insurance companies to address billing and reimbursement concerns.

• Identify and rectify claim errors, eligibility issues, authorization gaps, and payer rejections.

• Submit corrected claims and manage appeals as needed.

• Ensure accurate documentation and status updates for claims within internal systems.

• Monitor aging claims and proactively escalate high-risk accounts or issues with payers.

• Work closely with intake, credentialing, clinical, and operations teams to swiftly resolve claim blockers.

• Guarantee timely and accurate workflows related to reimbursement and collections.

• Consistently enhance billing workflows, operational efficiency, and claim turnaround times.

⛳️ Requirements

• Previous experience in U.S. healthcare billing or revenue cycle management is essential.

• Experience with Medicare and commercial insurance payers is highly preferred.

• Strong comprehension of claims submission, management of denials, appeals, and payer follow-up workflows.

• Highly detail-oriented and organized.

• Excellent written and verbal communication skills in English.

• Comfortable managing high-volume operational tasks with efficiency and precision.

• Ability to work independently in a fast-paced setting.

• Experience with EHRs, billing systems, clearinghouses, or insurance portals is preferred.

🏝️ Benefits

• A mission with impact; help provide life-changing care to a population that is often overlooked.

• A remote-first team, allowing flexibility in remote work while maintaining close connections with a thoughtful, collaborative team focused on purpose.

• Opportunities for growth and ownership; be part of a small, agile team where you'll take initiative, influence key processes, and develop as we expand.

• Make someone's day every day; your work helps older adults and their families feel recognized, supported, and cared for.