Medical Biller

Responsibilities:

Coding and Billing:

• Accurately assign ICD-10, CPT, and HCPCS codes to diagnoses and procedures.
• Ensure all codes are sequenced correctly and comply with insurance regulations.
• Prepare and submit insurance claims for reimbursement.

Documentation and Verification:

• Review patient charts and documents for accuracy and completeness.
• Follow up on any missing or unclear information with medical staff.
• Maintain detailed records of all billing and coding activities.

Insurance, Referral and Patient Communication:

• Communicate with insurance companies to resolve discrepancies and follow up on unpaid claims.
• Respond to inquiries from patients regarding billing issues and account status.
• Identify and bill secondary or tertiary insurances as needed.
• Able to communicate effectively with other medical professionals regarding patients that are referred to the clinic
• Able to understand insurance criteria for a variety of treatments and obtain prior authorizations

Compliance and Confidentiality:

• Adhere to HIPAA regulations and maintain patient confidentiality.
• Stay updated on changes in billing regulations and procedures.

Reporting and Audits:

Weekly and Monthly

• Generate detailed monthly reports on billing activities, including the number of claims submitted, payments received, and outstanding balances.
• Generate weekly reports on billing activities and financial status.
• Conduct weekly audits to compare Explanation of Benefits (EOBs) with submitted claims.
• Identify discrepancies such as down-coded claims, partial payments, or denials.
• Review audit findings to determine necessary follow-up actions.
• Engage with payors to resolve discrepancies and ensure accurate reimbursement.

Qualifications:

• Certified Professional Coder (CPC) or equivalent certification.
• Minimum of 2 years of experience in medical billing and coding.
• Proficiency in using billing software (Akamai Practice Management) and electronic health records (EHR) systems (Elation).
• Strong understanding of medical terminology, anatomy, and physiology.
• Excellent attention to detail and organizational skills.
• Ability to communicate effectively with medical staff, insurance companies, and patients

About Us

Company Name: GOTEAM

Achievements:

• Consistently raising the bar in employee engagement with an 85% score—outperforming global and US averages significantly.
• Certified as a Great Place to Work for four years running—demonstrating our commitment to excellence.
• Over 1,000 employees strong, with ambitious plans for growth.

Culture:

• Innovation isn’t just part of the job—it’s the job. We celebrate diversity and create an environment for personal and professional growth.

Mission:

• Our mission is bold and simple: provide 100,000 people with free AI certification through the Vjal Institute, fueling the future of innovation.

Location:

Headquartered in the Philippines, with ambitious plans to expand globally by 2025.

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