USA HEALTHCARE INSURANCE/BILLING EXPERT

The Medical/Insurance Biller is responsible for submitting medical claims to insurance companies and payers such as Medicare, AETNA, BCBS, CIGNA, UHC, UMR, etc. They play a crucial role in the revenue cycle management process within a healthcare facility.

Responsibilities and Duties:
Review patient bills for accuracy and completeness and obtain any missing information.
Prepare, review, and transmit claims using billing software, including electronic and paper claim processing.
Follow up on unpaid claims within standard billing cycle timeframe.
Check each insurance payment for accuracy and compliance with contract discount.
Identify and bill secondary or tertiary insurances.
Review all insurance explanation of benefits statements for accuracy and completeness.
Research and appeal denied claims.
Answer all patient or insurance telephone inquiries.
Work on collection accounts.
Update billing software with rate changes.
Update cash spreadsheets, and running collection reports.
Maintain strict confidentiality.
Coordinate with physicians and other healthcare providers to ensure all necessary information is obtained to secure payment.

Qualifications:
Philippine Registered Nurse ONLY
Medical or clinical experience is a plus
Previous experience as a medical insurance/billing or in a related role is preferred.
Knowledge of insurance guidelines including HMO/PPO, Medicare, AETNA, BCBS, CIGNA, UHC, UMR and other payer requirements and systems.
Familiar with medical terminology.
Proficient in Microsoft Office Suite and billing software.
Excellent communication and problem-solving skills.
Ability to multitask and manage patient accounts.
Detail oriented and strong organizational skills are essential.
Ability to work independently and in a team environment.
Knowledge of medical billing/collection practices.
Knowledge of computer systems and software used in functional area.
Knowledge of business office procedures.
Ability to maintain patient confidentiality and adhere to HIPAA regulations.

The ideal candidate:
Confidence in their ability to improve a person’s health through nutrition and diet
Ability to follow protocols and guidelines developed by the clinic for Nutrition
Ability to follow directions per the physician and work collaboratively
Fast paced
Positive and assertive
Works very well with physician and other colleagues
Communication skills need to be excellent
Punctual
Willing to get more training as needed
Medical insurance/billing
Medical experience is a plus
Sales experience is a plus
Customer service experience is a plus

Working Conditions:
This is a full-time/part-time position, and as this is a virtual/remote role, the candidate will need a suitable home office setup noise free and other requirements below:

Documents:
NBI clearance and/or Police clearance
ID preferably license/passport
Professional photo
Diploma & Transcript of records
Other certificates and license (if available)
References from previous work (managers and colleagues) *background check is a must
Cover letter : Why do you want to join our amazing team?

Technical:
Computer literate: Microsoft office suites, Google suites, EHR, tech savvy
Computer/Laptop
Webcam
Headset with noise cancellation
Working space with no background noise
Backup power (not required)

Hours: 20 to 30 hours/week (negotiable)

Company Overview:
We are an Internal Medicine/Medical weight loss practice.

We are seeking to hire an experienced PhRN to work as a VIRTUAL OPERATIONS MANAGER, MARKETING MANAGER, EXPERT MEDICAL SCRIBE, MEDICAL/INSURANCE BILLER.

This will be a very fulfilling and rewarding job as you help patient get healthier.

Our goal is to integrate qualified candidates into the daily flow of our Medical weight loss practice.

In this role you can expect first hand clinical exposure to a vast array of medical conditions and begin to develop an understanding of their medical management. This direct patient contact will also help to develop appropriate skills for communication in patient education and involvement in the coordination of their care.

Upon completion of working in this capacity, expect to have developed a better sense of professionalism in medicine, improved skills in effective communication and coordination of care for patients.

This is an excellent opportunity to get direct patient care and patient education experience.