Position Summary:

The Medical Billing Specialist will be responsible for managing and processing medical claims, ensuring accuracy, and maintaining compliance with relevant regulations. This role requires expertise in using Medisoft and/or eCW for payment posting, as well as a strong understanding of out-of-network health Insurance, Workers' Compensation, and Personal Injury Protection (PIP) claims in the U.S. The ideal candidate will be detail-oriented, capable of working in a fast-paced environment, and possess strong analytical skills.

Job Details:

  • Medical Billing Specialist
  • Work from home
  • Monday to Friday| 8 PM to 5 AM Manila Time

Responsibilities:

  1. Payment Posting:
    • Accurately post payments using Medisoft and/or eCW
    • Reconcile posted payments with Explanation of Payments
    • Identify and correct any discrepancies in payment posting
  2. Claims Management:
    • Process and manage Out of Network Health Insurance, Workers Compensation, and PIP claims
    • Ensure timely and accurate submission of claims
    • Follow up on unpaid or denied claims to ensure maximum revenue realization
  3. Data Analysis and Reporting:
    • Analyze billing data to identify trends, errors, and opportunities for improvement
    • Prepare and submit reports on billing activities and outcomes
    • Collaborate with the management team to develop strategies for optimizing billing processes
  4. Compliance and Documentation:
    • Maintain up-to-date knowledge of industry regulations and compliance
      requirements
    • Ensure all billing activities are compliant with relevant laws and guidelines
    • Accurately document all billing and claims activities

Qualifications:

  • Proven experience using Medisoft and/or eCW (eClinicalWorks) for payment posting
  • Strong knowledge of Out of Network Health Insurance, Workers Compensation, and PIP claims in the U.S
  • Exceptional attention to detail and accuracy
  • Ability to work efficiently in a fast-paced environment
  • Strong analytical and problem-solving skills
  • Ability to work independently and as part of a team
  • Proficiency in Microsoft Office Suite (Excel, Word, Outlook)