Medical Billing Specialist (ALB)

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)