Medical Biller

CF Solutions Philippines Inc.; Philippines; On-site; PHP 279,000 - 446,000; Full time

Job summary

CF Solutions Philippines Inc. is seeking a Medical Biller to ensure accurate processing of billing data and claims submission to insurance providers. The role emphasizes maximizing reimbursement and maintaining compliance across Medicare and other programs in a fast-paced setting.

The incumbent will review billing for errors, perform audits, and communicate with insurers and internal teams to resolve discrepancies and improve cash flow. Onsite work in Eastwood, Quezon City is required.

Qualifications

• Certification in medical billing and coding is preferred.
• Prior experience in medical billing or a similar role.
• Strong understanding of Medicare and private insurance billing procedures.
• Familiarity with billing software and EMR systems.
• Proficient in Microsoft Office (Word, Excel, etc.).

Responsibilities

• Post charges and prepare claims for submission to payers.
• Submit billing data to insurance providers with accuracy and timeliness.
• Process and follow up on claims to maximize reimbursement.
• Resolve denial instances and resubmit corrected claims as needed.
• Coordinate with insurers to address billing discrepancies.
• Audits of billing data to ensure accuracy and compliance.
• Review Medicare and applicable insurance programs for compliance.
• Deploy and maintain billing programs and provide reports on activity.
• Ensure all billing activities comply with regulations.
• Communicate with internal and external stakeholders in a timely manner.

Skills

Billing & coding certification

Medical billing experience

Billing software proficiency

EMR familiarity

MS Office proficiency

Job description

Job Summary

The Medical Biller will be responsible for accurately processing billing data, submitting claims to insurance providers, and ensuring maximum reimbursement for services provided. This role involves reviewing and correcting billing errors, resolving denial instances, and maintaining communication/visibility with insurance providers to facilitate smooth billing operations. The Medical Biller will also conduct audits and reviews for Medicare and alternative applicable insurance programs, ensuring compliance with relevant regulations. This position requires excellent attention to detail, knowledge of billing processes, and the ability to work in a fast-paced environment to meet deadlines.

Work Set Up: Work Onsite in Eastwood, Quezon City

Key Responsibilities and Duties

• Perform posting of charges and completion of claims for submission to various payers.
• Submit billing data to the appropriate insurance providers, ensuring accuracy and timeliness.
• Process and follow up on claims to ensure full reimbursement for services rendered.
• Resolve denial instances and resubmit corrected claims as necessary.
• Work with insurance providers to identify and address any billing discrepancies.
• Conduct audits of billing and claims data to ensure accuracy and compliance.
• Perform Medicare and alternative applicable insurance program reviews to ensure adherence to program requirements.
• Deploy and maintain various billing programs, providing regular reports on billing activities and reimbursement outcomes.
• Ensure all billing activities comply with federal and state regulations.
• Conduct duties in a professional and timely manner, maintaining communication with internal and external stakeholders.

Required Qualifications and Experience

• Certification in medical billing and coding is preferred.
• Prior experience in medical billing or a similar role, particularly in a medical device or healthcare setting.
• Strong understanding of Medicare and private insurance billing procedures.
• Familiarity with billing software and electronic medical records (EMR) systems.
• Proficient in Microsoft Office Suite (Word, Excel, etc.).

Required Communication and Competency Skills

• Strong verbal and written communication skills to interact effectively with insurance companies and internal teams.
• High level of accuracy in reviewing and processing claims and maintaining billing records.
• Ability to prioritize and manage multiple tasks in a time-sensitive environment.
• Ability to troubleshoot billing issues and resolve them efficiently, ensuring maximum reimbursement.