Medical Billing Specialist Home-based

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

Job Overview: We are seeking a dynamic and service-driven Medical Billing Specialist to join our team. In 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 Responsibilities

• This 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 issues
• Oversees patient accounts receivables including student health insurance plan (SHIP) and third-party claims.
• Monitor charges/revenue for accuracy and timeliness
• Must 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 system
• Checking 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 individuals
• Maintaining 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 coding
• Competent use of computer systems, software, and 10 key calculators
• Problem-solving skills to research and resolve discrepancies, denials, appeals, and collections
• Skills in organizing and reporting data that is accurate, complete, and accessible to other employees
• Portrays a calm manner and patience working with either patients, providers, or insurers during the billing process
• Excellent customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds
• Displays professionalism in their demeanor and in their communication - verbally and written
• Demonstrates the ability to handle a fast-paced environment by portraying strong multi-tasking skills
• Demonstrates the ability to prioritize tasks/responsibilities and complete duties within the allotted time
• Willing to seek out new methods and principles and be willing to incorporate them into existing practices
• Strong attention to detail and organizational skills
• Provides consistency and timeliness in attendance
• Willingness to be cross-trained in different tasks
  
  

Minimum Requirements

• Two years experience in medical practice billing
• Proficiency in MS Office
• Experience in eCW or Athena
  
  

Work Location

• Home-based
• Should have strong internet connection (minimum of 20 mbps)
• Should have own Laptop/PC (minimum of i5 8GB RAM)
  
  

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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