VA- Medical Biller

MCVO Talent Outsourcing Services; Makati; Remote; PHP 1,048,000 - 1,747,000; Full time

Job summary

MCVO Talent Outsourcing Services is hiring a Medical Biller – Outpatient Specialty for a permanent work-from-home role serving U.S. practices. You will manage end-to-end billing, verify eligibility, review CPT/ICD-10-CM/HCPCS coding, and follow up on unpaid claims.

The ideal candidate has 3+ years in U.S. medical billing, experience in outpatient specialties (Primary Care, Behavioral Health, ABA, Speech Therapy), and proficiency with common EMR/EHR systems.

Qualifications

• 3+ years of U.S. medical billing or revenue cycle management.
• Experience in outpatient specialties: Primary Care, Family Practice, Behavioral Health, ABA, Speech Therapy.
• End-to-end billing: claims submission, payment posting, denial management, AR follow-ups.
• Knowledge of CPT, ICD-10-CM, HCPCS and modifiers.
• Experience with Medicare, Medicaid and commercial payers.
• Ability to interpret EOBs/ERAs and resolve payment discrepancies.
• Excellent analytical, organizational, and communication skills.
• Ability to work independently in a remote setting.

Responsibilities

• Manage end-to-end medical billing for U.S. outpatient practices and specialty clinics.
• Review demographics, insurance information, and billing documentation for accuracy.
• Verify insurance eligibility, benefits, and prior authorizations.
• Review charges and submit claims to Medicare, Medicaid, and commercial payers.
• Ensure correct CPT/ICD-10-CM/HCPCS coding and modifiers.
• Monitor claim statuses and follow up on unpaid or denied claims.
• Investigate denials and submit corrected claims and appeals as needed.
• Post payments and reconcile with EOBs/ERAs.
• Manage AR follow-ups to reduce balances and improve collections.
• Identify underpayments and billing discrepancies.

Skills

Medical billing

CPT/ICD-10-CM/HCPCS

AR follow-ups

Denial management

Tools

Tebra

SimplePractice

eClinicalWorks

CharmHealth

Healthie

Job description

Medical Biller – Outpatient Specialty

Work Setup: Permanent Work From Home
Employment Type: Full-Time

Key Responsibilities

• Manage end-to-end medical billing processes for U.S. outpatient medical practices and specialty clinics.
• Review patient demographics, insurance information, and billing documentation for accuracy and completeness.
• Verify insurance eligibility, benefits, and prior authorization requirements.
• Review charges and submit accurate claims to Medicare, Medicaid, and commercial insurance payers.
• Ensure appropriate use of CPT, ICD-10-CM, HCPCS codes, modifiers, and place-of-service codes, as applicable.
• Monitor claim statuses and follow up on unpaid, rejected, and denied claims.
• Investigate claim denials, identify root causes, and submit corrected claims, appeals, and reconsiderations as appropriate.
• Perform payment posting and reconcile insurance payments against Explanation of Benefits (EOBs) and Electronic Remittance Advice (ERAs).
• Manage accounts receivable (AR) follow-ups to reduce outstanding balances and improve collections.
• Identify underpayments, billing discrepancies, and claim processing issues.
• Maintain accurate billing records and document collection activities.

Qualifications

• At least 3 years of experience in U.S. medical billing or revenue cycle management, preferably in outpatient specialties.
• Strong hands-on experience in outpatient medical specialties, particularly:
  • Primary Care and Family Practice
  • Behavioral Health
  • Applied Behavior Analysis (ABA)
  • Speech Therapy
• Experience handling end-to-end medical billing, including claims submission, payment posting, denial management, and AR follow-ups.
• Knowledge of CPT, ICD-10-CM, HCPCS codes, and modifiers.
• Experience working with Medicare, Medicaid, and commercial insurance payers.
• Familiarity with insurance eligibility verification, benefits investigation, and prior authorization processes.
• Ability to interpret EOBs and ERAs and investigate payment discrepancies.
• Strong understanding of claim denials, appeals, corrected claims, and timely filing requirements.
• Excellent analytical, organizational, and problem‑solving skills.
• Strong written and verbal communication skills.
• Ability to work independently and manage multiple tasks in a permanent work-from-home environment.

Preferred Technical Skills

Experience with the following EHR, EMR, and practice management systems is highly preferred:

• Tebra
• SimplePractice
• eClinicalWorks (ECW)
• CharmHealth
• Healthie

Experience with payer portals such as Availity and other insurance billing platforms is an advantage.