Billing Specialist - A373

The Billing Specialist role is for individuals with experience in medical billing and revenue cycle management, focusing on behavioral health. The role involves ensuring claim accuracy, managing billing queues, and supporting revenue cycle efficiency in a remote healthcare services organization.

Location: Remote (Philippines)

Responsibilities

• Review and resolve coding issues flagged in billing systems prior to claim submission.
• Identify and correct missing information, demographic mismatches, and coding inconsistencies.
• Ensure claims are submitted accurately and within payer timelines.
• Validate CPT, ICD-10, and modifier usage to support billing compliance.
• Monitor and resolve billing issues held within the EHR system.
• Coordinate with clinical and administrative teams to obtain missing documentation.
• Maintain clean billing queues by proactively addressing preventable claim holds.
• Escalate recurring workflow issues impacting claim submission efficiency.
• Process claims requiring secondary insurance billing and coordination of benefits.
• Attach primary EOB documentation where required.
• Follow up on secondary claims through resolution.
• Ensure accurate payer sequencing and claim routing.
• Track billing percentage metrics and identify trends impacting claim holds.
• Support operational reporting related to pre-submission performance.
• Recommend process improvements to reduce preventable delays.
• Maintain accurate documentation and billing activity records.

Requirements

• Minimum 1 year of experience in medical billing or revenue cycle management.
• Strong understanding of pre-submission workflows and claim editing processes.
• Experience working within an EHR platform.
• Knowledge of CPT, ICD-10, and modifier usage.
• Strong organizational skills and high attention to detail.
• Excellent written and verbal English communication skills.
• Ability to manage multiple priorities in a fast-paced environment.

Benefits

• Competitive Salary: Based on experience and skills
• Remote Work: Fully remote—work from anywhere
• Team Incentives: Recognition for maintaining 100% CRM hygiene and on-time reporting
• Generous PTO: In accordance with company policy
• Health Coverage for PH-based talents: HMO coverage after 3 months for full-time employees
• Direct Mentorship: Guidance from international industry experts
• Learning & Development: Ongoing access to resources for professional growth
• Global Networking: Connect with professionals worldwide