Medical Biller

Job Summary:

The Medical Biller is responsible for accurately managing billing operations, including processing billing data, submitting insurance claims, and ensuring optimal reimbursement for healthcare services. This role involves identifying and correcting billing errors, resolving claim denials, and maintaining effective communication with insurance providers to support efficient billing workflows. The Medical Biller will also perform audits and reviews, particularly for Medicare and other insurance programs, to ensure regulatory compliance. Success in this role requires strong attention to detail, a solid understanding of billing procedures, and the ability to thrive in a fast-paced environment.

Key Responsibilities:

Charge Posting & Claims Submission

• Accurately post charges and prepare claims for submission to various insurance payers.
• Submit billing information promptly and ensure all data is complete and accurate.
• Monitor and follow up on submitted claims to secure full reimbursement.

Claims Management & Resolution

• Investigate and resolve denied claims; resubmit corrected claims as needed.
• Collaborate with insurance providers to address and rectify billing discrepancies.

Auditing & Compliance Reviews

• Conduct regular audits of billing and claims data to ensure accuracy and compliance.
• Review Medicare and other insurance programs to verify adherence to applicable guidelines.

Program Oversight & Reporting

• Manage billing systems and tools, generating regular reports on billing performance and reimbursement trends.

Regulatory Compliance & Professional Conduct

• Ensure all billing practices comply with federal and state regulations.
• Maintain professional communication with internal teams and external partners, ensuring timely and accurate information exchange.

Qualifications:

• College Graduate of any 4 years course.
• Must have at least 1 to 2 years' experience as a Medical Biller (Non-Negotiable).
• Currently residing within or near Metro Manila only.
• Available to start ASAP
• Strong knowledge of Medicare and private insurance billing protocols.
• Proficiency with billing software and electronic medical records (EMR) systems.
• Skilled in Microsoft Office applications, especially Word and Excel.
• Excellent written and verbal communication skills for effective interaction with insurers and team members.