AdvancedMD Medical Billing Specialist (COB & Payer Follow-Up)

Virtual Innovations; Metro Manila; On-site; PHP 207,000 - 482,000; Full time

Job summary

Virtual Innovations is seeking an insurance revenue cycle specialist to support back-office claims processing. The role focuses on insurance discovery, eligibility verification, and secondary payer follow-up using AdvancedMD and payer portals.

You will handle EOB interpretation, COB rules, and communication with commercial and government payers to optimize reimbursements while maintaining strict PHI privacy and compliance standards.

Qualifications

• 1–3 years of US medical billing experience or revenue cycle background.
• Hands-on experience with AdvancedMD (PM/RCM) modules preferred.
• Strong understanding of COB rules, EOB interpretation, and payer rejections.
• Familiar with CPT/ICD-10 coding and claim modifiers.
• Proficient using major insurance portals and payer research tools.
• Maintains HIPAA compliance and protects PHI.

Responsibilities

• Perform proactive insurance discovery to identify active primary and secondary coverage for unbilled or demographic-rejected claims.
• Verify coverage dates, benefit caps, copays, deductibles, and authorization requirements using payer portals and clearinghouses.
• Update patient billing files in AdvancedMD to ensure clean claim submission on initial runs.
• Manage secondary insurance billing after primary adjudication (EOB/ERA review).
• Contact payers via phone and portals to resolve outstanding 2nd-party balances.
• Re-file claims with proper COB details and billing modifiers.
• Identify and correct billing errors or payer rejections preventing secondary payment.
• Use AdvancedMD daily to work aging reports, worklists, and claim hold queues.
• Document precise AR notes regarding payer status and timelines.
• Collaborate with pathology coding/billing team to resolve systemic blockers.

Skills

US Billing

AdvancedMD

COB

EOB Review

CPT/ICD-10

Payor Portals

HIPAA

Tools

Availity Portal

NaviNet

Job description

Virtual Innovations is seeking an insurance revenue cycle specialist to support back-office claims processing. The role focuses on insurance discovery, eligibility verification, and secondary payer follow-up using AdvancedMD and payer portals.

You will handle EOB interpretation, COB rules, and communication with commercial and government payers to optimize reimbursements while maintaining strict PHI privacy and compliance standards.