Medical Biller – SME

Jobtailor; Philippines; On-site; PHP 223,000 - 357,000; Full time

Job summary

Jobtailor is seeking an experienced medical billing specialist to manage charges, payments, and claim processing. You will verify eligibility, work with payers, and ensure HIPAA compliance while handling PHI.

The role supports hybrid night shifts at Eastwood City, Quezon City, with remote-work prerequisites. You will use AdvancedMD, Athena, Epic, Waystar, and other EMR/EHR systems to post transactions, read superbills, and pursue denied claims, ensuring timely reimbursements and accurate patient

Qualifications

• Medical billing experience with proficiency in patient accounts and claims processing.
• Experience using an EHR/EMR portal such as AdvancedMD, Athena, Epic, Waystar, EClinicalWorks, Practice Fusion, or PointClickCare.
• Ability to perform eligibility verification and precertification with insurance companies.
• Ability to call payers for claim status and document results in the system.
• Ability to read superbills and perform charge entry in a practice management system.
• Ability to post ERA and EOB transactions.
• Knowledge of insurance guidelines (HMO/PPO, Medicare, Medicaid).
• Knowledge of denial management.
• HIPAA compliance.
• Credentialing knowledge is an added advantage.
• Remote-work equipment provided and hybrid night-shift at Eastwood City office.

Responsibilities

• Post medical charges, payments, and journal entries to patient accounts accurately and promptly
• Work with insurance companies, healthcare providers, and patients to process and obtain payment for claims
• Verify insurance filing information and patient eligibility and benefits
• Verify receipt of patient registration data and notify clients of potential coding problems
• Prepare, review, and transmit electronic and paper claims using billing software
• Follow up on unpaid claims within the standard billing cycle
• Research and appeal denied claims
• Meet individual and departmental quality and productivity standards
• Handle protected health information consistently with HIPAA
• Review patient bills for accuracy and completeness and obtain missing information
• Perform eligibility verification and precertification through web or verbal communication with insurers
• Call insurance companies for claim status, document findings in the system, and work with different payers
• Read superbills and enter charges in the practice management system
• Post ERA and EOB transactions from various systems and websites

Skills

Medical Billing Experience

Eligibility Verification

Claims Processing

Denial Management

Charge Entry

Posting ERA

Posting EOB

HIPAA Compliance

Credentialing Knowledge

Tools

AdvancedMD

Athena

Epic

Waystar

EClinicalWorks

Practice Fusion

PointClickCare

Billing Software

Practice Management System

Remote Work Equipment

Job description

• Post medical charges, payments, and journal entries to patient accounts accurately and promptly
• Work with insurance companies, healthcare providers, and patients to process and obtain payment for claims
• Verify insurance filing information and patient eligibility and benefits
• Verify receipt of patient registration data and notify clients of potential coding problems
• Prepare, review, and transmit electronic and paper claims using billing software
• Follow up on unpaid claims within the standard billing cycle
• Research and appeal denied claims
• Meet individual and departmental quality and productivity standards
• Handle protected health information consistently with HIPAA
• Review patient bills for accuracy and completeness and obtain missing information
• Perform eligibility verification and precertification through web or verbal communication with insurers
• Call insurance companies for claim status, document findings in the system, and work with different payers
• Read superbills and enter charges in the practice management system
• Post ERA and EOB transactions from various systems and websites

Requirements

• Medical billing experience; application options include less than 1 year, 1–3 years, 3–5 years, or 5 years and above
• Experience using an EHR/EMR portal, such as AdvancedMD, Athena, Epic, Waystar, eClinicalWorks, Practice Fusion, or PointClickCare
• Ability to perform eligibility verification and precertification with insurance companies
• Ability to call payers for claim status and document results in the system
• Ability to read superbills and perform charge entry in a practice management system
• Ability to post ERA (Electronic Remittance Advice) and EOB (Explanation of Benefits)
• Knowledge of insurance guidelines, including HMO/PPO, Medicare, and state Medicaid
• Knowledge of denial management
• Ability to handle protected health information in accordance with HIPAA
• Credentialing knowledge is an added advantage
• Necessary remote-work equipment: laptop/desktop, reliable internet, webcam, noise-cancelling headset, and dedicated workspace at home
• Openness to a hybrid night-shift schedule at the Eastwood, Quezon City office

Core Competencies

Demonstrates expertise in medical billing processes, including charge entry, claims processing, and eligibility verification, while ensuring compliance with HIPAA regulations. Proficient in using EHR/EMR systems and managing denied claims effectively.

Highest-signal resume keywords

• Medical Billing Experience
• EHR/EMR Portal Proficiency
• Eligibility Verification
• Claims Processing
• HIPAA Compliance

ATS Optimization Keywords

Hard Skills

• Charge Entry
• Claims Processing
• Eligibility Verification
• Denial Management
• Superbill Reading
• Posting ERA
• Posting EOB
• Insurance Guidelines Knowledge
• Credentialing Knowledge
• Payment Posting

Soft Skills

• Attention to Detail
• Communication Skills
• Problem-Solving Skills
• Organizational Skills
• Time Management

Industry Keywords

• HIPAA
• HMO
• PPO
• Medicare
• Medicaid
• Electronic Remittance Advice
• Explanation of Benefits
• Claim Status
• Patient Accounts
• Protected Health Information

Tools & Technologies

• AdvancedMD
• Athena
• Epic
• Waystar
• EClinicalWorks
• Practice Fusion
• PointClickCare
• Billing Software
• Practice Management System
• Remote Work Equipment