Medical Billing Specialist (Initial Claims Biller)

Eastvantage Group; Quezon City; On-site; PHP 279,000 - 469,000; Full time

Job summary

Eastvantage Group is seeking a Billing Specialist in the Philippines to ensure accurate and timely submission of claims to payers, with a focus on clean claim rates and compliance.

The role emphasizes precise claim preparation, documentation, and collaboration with internal teams to standardize billing practices and improve efficiency. Strong knowledge of Medicaid/Medicare/VA coverage and payer requirements is a plus.

Qualifications

• Experience in initial claims submission; creating clean claims from scratch is highly required.
• Customer service experience preferred
• Excellent follow-up, time management, and communication skills required
• Proficiency in MS Office Suite (Outlook, Word, Excel) is required
• Familiar with Careclaim MB software (prefer)
• Back-office support & Email customer invoicing

Responsibilities

• Prepare and submit accurate claims in accordance with payer guidelines and customer billing cycles.
• Ensure all claim details are complete and error-free, including coding, provider information, and service dates.
• Review claims for accuracy and compliance with Medicaid, Medicare, VA, and payer regulations
• Verify correct taxonomy codes, modifiers, and billing procedures to prevent rejections.
• Maintain a high clean-claims submission rate by thoroughly reviewing and validating claim information before submission.
• Ensure compliance with industry regulations, payer policies, and internal billing procedures.
• Maintain accurate and organized billing records and documentation
• Identify and report billing trends, potential errors, and areas for process improvement.
• Collaborate with internal teams to standardize billing practices and enhance efficiency.
• Support billing audits and internal quality control measures
• Other duties as assigned.

Skills

Customer service

Attention to detail

Time management

Communication

MS Office

Tools

Careclaim MB

Billing software

Job description

The Billing Specialist is responsible for ensuring the accurate and timely submission of claims to payers, maintaining compliance with industry standards, and ensuring billing accuracy. This role focuses on precise claim preparation, attention to detail, and proper documentation to minimize errors and maximize clean claim rates. The ideal candidate will have a strong understanding of medical billing practices and payer requirements.

What You'll Do:

• Prepare and submit accurate claims in accordance with payer guidelines and customer billing cycles.
• Ensure all claim details are complete and error-free, including coding, provider information, and service dates.
• Review claims for accuracy and compliance with Medicaid, Medicare, VA, and payer regulations
• Verify correct taxonomy codes, modifiers, and billing procedures to prevent rejections.
• Maintain a high clean-claims submission rate by thoroughly reviewing and validating claim information before submission.
• Ensure compliance with industry regulations, payer policies, and internal billing procedures.
• Maintain accurate and organized billing records and documentation
• Identify and report billing trends, potential errors, and areas for process improvement.
• Collaborate with internal teams to standardize billing practices and enhance efficiency.
• Support billing audits and internal quality control measures
• Other duties as assigned.

What We're Looking For:

• Experience in initial claims submission; creating clean claims from scratch is highly required
• Customer service experience preferred
• Excellent follow-up, time management, and communication skills required
• Proficiency in MS Office Suite (Outlook, Word, Excel) is required
• Familiar with Careclaim MB software (prefer)
• Back-office support & Email customer invoicing

#revenuecyclemanagement #billing #claimsprocess #endtoendclaims #fullcyclebilling #epic #emr #availity #medicaid #veteransaffair #startasap