PHRN Medical Biller (Virtual Assistant) - Onsite

We are seeking for a PHRN - Medical Biller to join our team. As a Medical Biller, you will play a crucial role in ensuring efficient and accurate billing processes for our clients in the healthcare sector. You will be responsible for reviewing and submitting claims, following up on unpaid claims, and resolving any billing-related issues to maximize reimbursement.

Key Responsibilities:
Medical Billing and Claims Processing:

Prepare and submit clean claims to insurance companies via electronic and paper submissions.

Verify patient insurance eligibility and benefits before submitting claims.

Ensure correct coding (CPT, ICD-10, HCPCS) for procedures and diagnoses to avoid claim denials.

Process claims for multiple specialties (if applicable) and handle payer-specific billing requirements.

Manage workers' compensation, auto accident, and out-of-network claims when necessary.

Accounts Receivable & Follow-Ups:

Monitor claim status, track denials, and resubmit corrected claims as needed.

Follow up with insurance providers on unpaid or rejected claims, appealing denials when appropriate.

Contact patients regarding outstanding balances and set up payment plans as necessary.

Post payments from insurance companies and patients, ensuring accurate reconciliation.

Compliance & Documentation:

Ensure HIPAA compliance and maintain confidentiality of patient information.

Keep detailed and accurate records of claims, payments, denials, and patient accounts.

Stay updated on insurance policies, coding changes, and billing regulations.

Requirements
Amenable to work onsite, night shift schedule

Must be a licensed Philippine Registered Nurse (PHRN), USRN is a PLUS.

2+ years of experience in medical billing and revenue cycle management.

Experience working with U.S.-based medical practices or billing companies.

Strong knowledge of insurance claims processing, denials management, and AR follow-ups.

Experience with medical coding (CPT, ICD-10, HCPCS), EOB interpretation, and modifiers.

Proficiency in medical billing software (e.g., Kareo, eClinicalWorks, AdvancedMD, DrChrono, etc.).

Familiarity with CMS guidelines, Medicare, Medicaid, and commercial insurance billing.

Excellent communication skills (written and verbal) in English.

Ability to work independently, meet deadlines, and handle multiple tasks efficiently.