Medical Billing Specialist

Job Expectations:

• Position Type: Experienced - Individual Contributor
• Employment Type: Full-Time; Permanent (Direct Hire)
• Work Setup & Location: Onsite - Ortigas, Pasig (hybrid depends on performance after a few months)
• Work Schedule: Weekdays; Night Shift
• Number of Headcounts: 10+ FTEs Available
• Industry: Outsourcing and Offshoring Consulting (Home Care)

About the Job:

We are seeking a Billing Specialist to join our client's team and support accurate and timely healthcare billing operations. In this role, you will be responsible for preparing, reviewing, and submitting claims in compliance with payer requirements and industry standards. The position focuses on attention to detail, documentation accuracy, and maintaining high clean-claim rates to support efficient reimbursement processes across government and third-party payers.

Key Responsibilities:

• Prepare and submit accurate billing claims in accordance with payer guidelines and established billing cycles.
• Review claims thoroughly to ensure completeness, accuracy, and compliance, including coding, provider details, and service dates.
• Ensure adherence to Medicaid, Medicare, VA, and other payer regulations and requirements.
• Validate taxonomy codes, modifiers, and billing procedures to minimize rejections and denials.
• Maintain a high clean-claims submission rate through detailed claim review and validation.
• Ensure compliance with industry regulations, payer policies, and internal billing procedures.
• Maintain accurate, well-organized billing records and supporting documentation.
• Identify billing trends, potential errors, and opportunities for process improvement.
• Collaborate with internal teams to standardize billing practices and improve operational efficiency.
• Support billing audits and internal quality assurance initiatives.
• Perform other related duties as assigned.

Qualifications:

• Bachelor's Degree in Finance, Business Administration, or a related field.
• Experience in healthcare billing or related billing functions is preferred.
• Customer service experience is an advantage.
• Strong follow-up, time management, and organizational skills.
• High attention to detail and ability to manage multiple priorities effectively.
• Proficiency in MS Office Suite, including Outlook, Word, and Excel.
• Possesses excellent interpersonal and English communication (written & verbal) skills.
• Can start immediately, if possible.

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