Medical Billing and Coding Specialist

Ruby Staffing Inc; Quezon City; Sur place; PHP 223 000 - 446 000; Plein temps

Résumé du poste

Ruby Staffing Inc is seeking a Medical Billing and Coding Specialist in the Philippines to review records, assign codes, and process insurance claims. You will verify eligibility, resolve denials, and ensure compliant billing practices.

The role requires knowledge of ICD-10-CM, CPT, and HCPCS, with attention to detail and strong analytical and communication skills. Experience in U.S. healthcare billing is a plus.

Qualifications

• Knowledge of medical billing and coding procedures.
• Familiarity with ICD-10-CM, CPT, and HCPCS coding systems.
• Understanding of insurance claims processing and reimbursement procedures.
• Strong attention to detail and accuracy.
• Good analytical, organizational, and problem-solving skills.
• Ability to handle confidential information in compliance with privacy rules.
• Effective written and verbal communication skills.

Responsabilités

• Review patient medical records and documentation for accuracy.
• Assign diagnoses and procedure codes using ICD-10-CM, CPT, and HCPCS.
• Prepare, submit, and follow up on medical insurance claims.
• Verify patient insurance eligibility, benefits, and coverage.
• Identify and correct claim errors and denials.
• Communicate with insurance companies and providers to resolve issues.
• Follow up on outstanding accounts receivable and unpaid claims.
• Ensure compliance with healthcare regulations and payer guidelines.
• Maintain accurate patient billing records.
• Protect patient information under HIPAA and privacy requirements.

Connaissances

Medical billing procedures

ICD-10-CM/CPT/HCPCS familiarity

Insurance claims processing

Attention to detail

Analytical and organizational skills

Confidential information handling

Written and verbal communication

Formation

CPB Certification

CPC Certification

CBCS Certification

Description du poste

The Medical Billing and Coding Specialist is responsible for reviewing patient medical records, assigning accurate medical codes, processing insurance claims, and ensuring timely reimbursement from insurance companies and patients. The role requires knowledge of medical billing procedures, coding guidelines, insurance requirements, and healthcare regulations.

Key Responsibilities

• Review patient medical records and clinical documentation to ensure accuracy and completeness.
• Assign appropriate medical codes for diagnoses, procedures, and services using ICD-10-CM, CPT, and HCPCS coding systems, as applicable.
• Prepare, submit, and follow up on medical insurance claims.
• Verify patient insurance eligibility, benefits, and coverage.
• Identify and correct claim errors, denials, and billing discrepancies.
• Communicate with insurance companies and healthcare providers to resolve claim issues.
• Follow up on outstanding accounts receivable and unpaid claims.
• Ensure compliance with applicable healthcare regulations, payer policies, and billing and coding guidelines.
• Maintain accurate patient billing records and documentation.
• Protect confidential patient information in accordance with HIPAA and other applicable privacy requirements.

Qualifications and Certifications

Candidates may hold one or more of the following certifications:

• Certified Professional Biller (CPB): Focuses on medical billing, insurance claims processing, reimbursement, payment posting, denial management, and accounts receivable follow-up.
• Certified Professional Coder (CPC): Focuses on medical coding, including assigning accurate diagnosis and procedure codes based on clinical documentation and applicable coding guidelines.
• Certified Billing and Coding Specialist (CBCS): Covers medical billing and coding, insurance claim processing, patient records, reimbursement procedures, and related administrative responsibilities.

Required Skills

• Knowledge of medical billing and coding procedures.
• Familiarity with ICD-10-CM, CPT, and HCPCS coding systems, as applicable to the role.
• Understanding of insurance claims processing, denials, and reimbursement procedures.
• Strong attention to detail and accuracy.
• Good analytical, organizational, and problem-solving skills.
• Ability to manage confidential information and meet productivity and quality standards.
• Effective written and verbal communication skills.

Preferred Experience

Previous experience in U.S. healthcare medical billing, coding, insurance claims processing, or revenue cycle management is preferred.