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 | 9:00 PM to 6:00 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