Senior Medical Billing Specialist | Ortigas

Connext Global Solutions Inc; Metro Manila; On-site; PHP 424,000 - 580,000; Full time

Benefits offered by this job

Night differential

Attendance bonus

Mid-year bonus

Competitive pay

Life insurance

HMO insurance

Great culture

Job summary

Connext Global Solutions Inc is hiring a Senior Medical Billing Specialist to join our US client support team. You will verify patient eligibility and benefits, obtain prior authorizations, and handle therapy services such as Physical Therapy, Occupational Therapy, Speech Therapy, Autism Therapy, and Outpatient Behavioral Health.

You will coordinate with providers, follow up with insurers, ensure HIPAA compliance, and optimize workflows.

Qualifications

• Minimum of one (1) year experience with medical billing and/or understanding of benefits including deductibles, co-insurance, out of pocket and benefits exclusions.
• Experience with EMR/EHR and PMS systems.
• Phone etiquette and customer service skills when contacting insurers.
• Familiarity with HMOs, PPOs, POSs, EPOs, Medicare and Medicaid through referral and authorization processes.

Responsibilities

• Verify patient eligibility, benefits, referrals, and authorization requirements across multiple payers and specialties.
• Complete prior authorizations through insurance portals and direct payer calls within required SLAs.
• Coordinate with providers to collect accurate patient and medical records for authorization requests.
• Follow up with insurers and provide additional documentation to secure timely authorization approvals.
• Manage multiple prior authorizations simultaneously and optimize workflows for consistent performance.
• Serve as a subject matter expert on payer authorization processes while maintaining HIPAA compliance and confidentiality.

Skills

Phone etiquette

Customer service

HIPAA compliance

Tools

EMR/EHR

PMS

Job description

Req ID: 4987
Connext is a dedicated team of business process outsourcing experts and innovators, with experience in supporting world-class companies in Title and Escrow, Healthcare, Produce Distribution, Retail and Fashion, Design Consulting, and Finance.

We are currently looking for a Senior Medical Billing Specialist who will be working with Connext's Client in the United States of America.

What's in it for you?

• 25% Night Differential
• Perfect Attendance Bonus
• Mid-year Bonus!
• Competitive compensation
• Life insurance
• HMO Insurance
• Great company culture

What is the job?

The Senior Medical Billing Specialist is responsible for conducting insurance verifications and obtaining prior authorizations for a diverse range of therapy services, including Physical Therapy, Occupational Therapy, Speech Therapy, Autism Therapy, and Outpatient Behavioral Health.

Responsibilities:

• Verify patient eligibility, benefits, referrals, and authorization requirements across multiple payers and specialties.
• Complete prior authorizations through insurance portals and direct payer calls within required SLAs.
• Coordinate with providers to collect accurate patient and medical records for authorization requests.
• Follow up with insurers and provide additional documentation to secure timely authorization approvals.
• Manage multiple prior authorizations simultaneously and optimize workflows for consistent performance.
• Serve as a subject matter expert on payer authorization processes while maintaining HIPAA compliance and confidentiality.

Qualifications:

• Minimum of one (1) year experience with medical billing and/or understanding of benefits including deductibles, co-insurance, out of pocket and benefits exclusions.
• Experience in providers software, including Electronic Medical Record Systems (EMR/EHR) and Practice Management Systems (PMS).
• Phone etiquette and customer service skills, experience calling insurers to collect benefits and confirm authorization status.
• Has understanding with HMOs, PPOs, POSs, EPOs, Medicare, Medicaid through the referral and authorization process.
• Familiarity with navigating insurance portals.
• Demonstrates strong understanding of insurance policies and medical billing processes including CPT coding.