The Medical Billing Specialist plays a critical role in managing the complete billing cycle, including Revenue Cycle Management (RCM) and Accounts Receivable (A/R). This role ensures efficient billing operations by handling claims, investigating denials, and performing end-to-end billing tasks to optimize revenue for healthcare practices.
Key Responsibilities:
- End-to-End Revenue Cycle Management (RCM): Oversee the entire billing cycle from claims submission to final reimbursement, ensuring each step is accurately and efficiently managed.
- Accounts Receivable (A/R) Collections: Track and manage unpaid bills, performing follow-ups on outstanding claims and resolving collection issues to maximize revenue.
- Claims Denial Investigation and Resolution: Investigate denied claims, identify errors or required corrections, and resubmit claims with appropriate adjustments.
- Claims Resubmission and Correction: Manage backend tasks related to claim resubmission, verifying accuracy, and implementing corrections as needed to avoid delays in reimbursement.
- Documentation and Compliance: Ensure all billing activities are documented by regulatory standards and compliance requirements, including HIPAA.
Requirements
- Proven experience in medical billing with exposure to RCM and A/R processes.
- Experience with claim denial management and collections processes.
- Proficiency in English communication, both written and verbal.
- Proficient in virtual office tools, EHR systems, and communication platforms.
- Strong customer service and critical thinking skills.
- Understanding of HIPAA regulations and the importance of patient data confidentiality.
- Strong problem-solving skills and ability to work with minimal supervision.
- Willingness to work in US time zones (PST, EST, CST).
- High school diploma or equivalent.
System and Work Setup Requirements:
- Internet: Minimum speed of 25 Mbps or higher, with a reliable backup connection available in case of power outages or service provider issues.
- Processor: Intel Core i5 7th Generation or higher (or equivalent).
- Memory: 8 GB RAM.
- Storage: 256 GB SSD or HDD with at least 50% free space available.
- Webcam: 720p resolution or higher.
- Operating System: Windows 10 or later (or equivalent).
- Audio Equipment: Noise-canceling earphones or headset.
- Workspace: A designated, quiet, and organized workspace free from distractions to ensure productivity and focus.
Benefits
- Permanent remote work setup
- Competitive starting rate paid in USD
- Internet Allowance
- HMO insurance (PH)
- Retirement Fund
- Paid US holidays
- Paid Vacation and Sick Leaves