Medical Billing Specialist (Home-based)

Job DescriptionAbout Us:Outsourced is a leading Philippines outsourcing company providing dedicated remote staff and offshore staffing services. We specialise in providing staff of the highest quality who will continue to exceed your expectations and provide benchmark offshore solutions to your business. With Outsourced you can scale your organisation quickly, easily and cost effectively with dedicated remote staff based in our modern offices in Manila.Job OverviewIn this role, you will be responsible for performing a variety of daily, weekly, and monthly revenue cycle tasks, while also supporting overall billing operations and process improvement efforts.We are looking for a reliable, detail-oriented Medical Billing Specialist who thrives in a fast-paced environment and is committed to delivering excellent service—both individually and through collaboration with the team. Responsibilities include processing claims, posting payments, and ensuring accurate and timely billing for a medical clinic.Key ResponsibilitiesThis position is responsible for following patient accounts through the entire billing process from eligibility to completion of payment process.Providing medical billing and collection processes by verifying eligibility and benefits, obtaining pre-authorizations, entering medical codes, requesting payments, and resolving account issuesOversees patient accounts receivables including student health insurance plan (SHIP) and third-party claims.Monitor charges/revenue for accuracy and timelinessMust have thorough knowledge of federal and commercial payers and stay up to date with coverage changes.Provides customer service to patients by educating them on insurance policies, billing procedures and coding issues.May contact patients and insurance companies for payment requests, overdue payments, denied claims, and arrange payment plans.Coordinates and resolves denials including the appeals process.Processes changes in systems to support accurate and efficient billing processes.Preparing, reviewing, and transmitting clinical charges, including updating procedure and diagnosis codes in computer files, coordinating reports, maintaining fee schedules, and the posting of payments.Balancing a daily input and accounts receivable systemChecking eligibility and benefits verification for treatments, hospitalizations, and procedures.Reviewing patient bills for accuracy and completeness and obtaining any missing information.Checking each insurance payment for accuracy and compliance with contract discount. Contacting insurance companies regarding any discrepancy in payments if necessary. Researching and appealing denied claims.Answering patient and insurance telephone inquiries pertaining to assigned accounts. Collecting delinquent accounts by establishing payment arrangements with patients and following up with patients when payment lapses occur.Remaining alert to special billing rules and communicating those to appropriate individualsMaintaining patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Maintaining and updating contract and credentialing information with insurance payers on behalf of providers and clinics.Other duties as assigned.Essential Skills & Qualifications:Familiarity with CPT and ICD-10 codingCompetent use of computer systems, software, and 10 key calculatorsProblem-solving skills to research and resolve discrepancies, denials, appeals, and collectionsSkills in organizing and reporting data that is accurate, complete, and accessible to other employeesPortrays a calm manner and patience working with either patients, providers, or insurers during the billing processExcellent customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgroundsDisplays professionalism in their demeanor and in their communication - verbally and writtenDemonstrates the ability to handle a fast-paced environment by portraying strong multi-tasking skillsDemonstrates the ability to prioritize tasks/responsibilities and complete duties within the allotted timeWilling to seek out new methods and principles and be willing to incorporate them into existing practicesStrong attention to detail and organizational skillsProvides consistency and timeliness in attendanceWillingness to be cross-trained in different tasksMinimum Requirements:Two years' experience in medical practice billingProficiency in MS OfficeExperience in eCW or AthenaWork Schedule: Tuesday - Saturday, 12:00 AM - 9:00 AM Manila TimeWork Setup: Home-basedShould have strong internet connection (minimum of 50 mbps)Should have own Laptop/PC Note: As part of our recruitment process, we conduct a background check on all hired candidates. 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