MEDICAL BILLER

Job Description

About Us:

Outsourced.ph is a leading ISO-certified Philippines offshore outsourcing company that provides dedicated remote staff to some of the worlds leading international companies. Outsourced is recognized as one of the Best Places to Work and has achieved Great Place to Work Certification. We are committed to providing a positive and supportive work environment where all staff can thrive. As an Outsourced staff member, you will enjoy a fun and friendly working environment, competitive salaries, opportunities for growth and development, work-life balance, and the chance to share your passion with a team of over 1,000 talented professionals.

About The Role

We are seeking a detail-oriented, process-driven Medical Billing Supervisor to oversee claims operations, accounts receivable management, and a small billing team (up to 2 billers). This individual will be responsible for driving collections performance, managing denials and appeals, and reporting on key revenue cycle metrics. The ideal candidate is data-literate, comfortable with audits and oversight, and laser-focused on dollars collected while respecting governance and reporting boundaries.

Key Responsibilities

Claims & Billing Execution

• Oversee the end-to-end claims lifecycle, ensuring accurate and timely submission
• Monitor clearinghouse rejections and ensure rapid correction
• Manage resubmissions, corrected claims, and appeals
• Ensure compliant documentation and payer-specific requirements are met
  
  

Accounts Receivable (AR) Management

• Actively manage AR worklists by aging bucket (0-30 / 31-60 / 61-90 / >90 days)
• Prioritize high-dollar and high-risk claims
• Escalate AR >90 days per clinic escalation policy
• Maintain payer follow-up documentation in eClinicalWorks
  
  

Team Supervision

• Supervise billing associates and team leads (up to 2 direct reports)
• Assign daily and weekly work queues
• Enforce SOPs, productivity, and quality standards
• Escalate performance issues to clinic leadership
  
  

KPI Tracking & Reporting

• Track and report clinic-defined KPIs: net collection rate, days in AR, AR >90 days, denial rate, clean claim rate, and underpayment recovery
• Prepare monthly KPI summaries with variance explanations
• Utilize Rivet and eClinicalWorks data to support reporting
  
  

Denials & Underpayment Resolution

• Execute Rivet underpayment and denial worklists
• Categorize, trend, and resolve denials
• Execute appeals for medical necessity, coding, eligibility, and timely filing issues
• Track appeal success rates and turnaround times
  
  

Compliance & Process Improvement

• Draft and send appeals per clinic standards of operations for payer-denied claims
• Ensure HIPAA compliance and data security standards
• Coordinate with external consultants or auditors when requested
• Support payer audits and documentation requests
• Identify root causes of billing errors and implement corrective actions
• Maintain SOP documentation and workflow updates
  
  

Requirements

• 3+ years in a supervisory or managerial medical billing and revenue cycle role
• Strong experience in AR follow-up, denials, and appeals
• Excellent documentation, communication, and organizational skills
  
  

Preferred Qualifications

• Hands-on experience with eClinicalWorks, Trizetto, and contract variance tools such as Rivet
• Prior offshore team management experience
• Familiarity with Texas payer mix (BCBS TX, UHC, WellMed, Aetna, Cigna, Humana)
  
  

Work Schedule:

• Monday-Friday, 11:00 PM-7:00 AM PHT (Manila Time) Monthly meeting every 2nd Wednesday of the month from 7:30-9:00 AM PHT (Manila Time)
  
  

Work Location:

• Home-based
• Should have a strong internet connection (minimum of 20 MBPS)
  
  

Note: As part of our recruitment process, we conduct a background check on all hired candidates. Please ensure that all required documents are prepared and submitted promptly.

By clicking on the "Im Interested" button, I hereby allow Outsourced Quality Assured Services, Inc. ("Outsourced") to store and collect my personal information for the purposes of employment application. As such, I agree and authorize Outsourced to collect, store, or continue to use my personal information for the above-stated purpose, and to retain my personal information for a period of 1 year, and for these purposes only.

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