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Medical Billing jobs in San Mateo

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    • Strong knowledge of prior authorization, medical coding, and medical A/R.
    • 2+ years of U.S. medical billing experience required, with primary focus on insurance…
    • Route claim concerns to the appropriate billing or clinical staff when escalation is needed.
    • Route tasks to the appropriate clinical, billing, or provider team.
    • Track and manage accounts receivable, ensuring aging amounts remain within targeted levels.
    • Regularly check the status of submitted claims to ensure timely…
    • Strong knowledge of prior authorization, medical coding, and medical A/R.
    • 2+ years of U.S. medical billing experience required, with primary focus on insurance…
    • As a Virtual Scribe you will be remotely connected to the internet with a U.S. doctor that is conducting a medical examination of a patient.
    • Everyday responsibilities include processing data from medical coders, ensuring claims get processed and paid, verifying insurance coverage, reviewing denied…
    • Helps patient understand their billing and insurance.
    • Provides basic information to patients about the medical procedures, treatment plans, and medications.
    • Experience in medical billing/AR collections.
    • Prepare invoices and reconcile billing with accounts receivables.
    • Familiarity with UB Claims and UB04 forms.
    • At least 2–4 years of experience in Medicaid billing or a similar remote billing role.
    • Verify eligibility prior to billing.
    • 100% remote / work-from-home setup.
    • 2+ years of medical collections/billing experience.
    • Utilize provider billing manuals to obtain billing guidelines and requirements.
    • Remains current on medical coding and billing guidelines and auditing protocols.
    • Review patient medical records and clinical documentation.
    • Maintain and process patient medical records.
    • Background in admin work, with strong interest in medical and diagnostic terms.
    • With experience in billing Medicare Part A.
    • Learn and implement specialty, state, carrier specific billing requirements.
    • Assure timely submission of claims.
    • Review daily, weekly, and monthly productivity reports of billing associates.
    • Conduct routine and random audits of healthcare billing transactions including…
    • Knowledgeable of billing and collection operation, work experience is an advance.
    • We aim to balance work, play, and life, as shown by our benefits such as free…

Job Post Details

Medical Billing Specialist (Home-based) - job post

OUTSOURCED QUALITY ASSURED SERVICES
3.8 out of 5 stars
Eastwood City
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Job details

Job type

  • Full-time

Location

Eastwood City

Full job description

Medical Billing Specialist (Home-based)

Full Time Employee

Job Summary

Night shift; Hybrid

Job Description

About Us:
Outsourced. ph is a leading ISO-certified Philippines offshore outsourcing company that provides dedicated remote staff to some of the world's leading international companies. Outsourced is recognized as one of the Best Places to Work and has achieved Great Place to Work Certification. We are committed to providing a positive and supportive work environment where all staff can thrive. As an Outsourced staff member, you will enjoy a fun and friendly working environment, competitive salaries, opportunities for growth and development, work-life balance, and the chance to share your passion with a team of over 1,000 talented professionals

Duties and Responsibilities

Accounts Receivable (A/R) Management
  • Actively manage assigned insurance A/R buckets to ensure timely follow-up and resolution.
  • Investigate and resolve unpaid, underpaid, or denied claims.
  • Submit corrected claims and appeals as needed, with strong documentation.
  • Submit and track appeals with supporting documentation.
  • Resolve coordination of benefits issues and update payer order when needed.
  • Handle refund requests and recoupments by documenting and escalating per policies.
  • Review aging reports to prioritize high dollar and time sensitive accounts; Identify trends in denials or delays and communicate root causes to leadership.
  • Maintain A/R aging targets and productivity benchmarks.
  • Maintain accurate, detailed account notes and follow internal workflow for documentation and escalation.
Process & Quality Improvement
  • Follow established billing workflows while identifying opportunities to improve efficiency and accuracy.
  • Maintain compliance with payer rules, HIPAA, data security, and internal policies.
  • Support audits, month-end close activities, and reporting requests as needed.
  • Contribute to a culture of accountability, responsiveness, and continuous improvement.

Metric Expectations
  • Within 90 Days:
    • Process 30-50 accounts per day including sending updated claims and accurately documenting the chart
    • Maintain 95% accuracy on account work and documentation (rework rate <5% where supervisor or team member must redo)
  • By End of First Year:
    • Process a minimum of 60+ accounts per day, including sending updated claims and accurately documenting the chart
    • Can manage full A/R queue for assigned payers with minimal supervision
    • Maintain 98% accuracy or higher on account work and documentation
    • Denials worked within 2 business days with consistent follow up and documentation

Requirements
  • College degree preferred but not required
  • 2+ years of U.S. medical billing experience required, with primary focus on insurance A/R clean up
  • Strong knowledge of full claims cycle
  • Ability to read and interpret ERAs/EOBs, denial reasons and remark codes, payer policies and timely filing rules
  • Strong knowledge of prior authorization, medical coding, and medical A/R
  • Familiarity with payer portals is a plus (Availity, UHC, Aetna, etc.)
  • Ability to solve problems and troubleshoot issues, high attention to detail
  • Strong written and verbal English communication skills to communicate with internal team members and external payors. Must be able to interpret and manage approval letters, denials, and requests for additional information
  • Comfortable making payer calls and communicating professionally with U.S.-based teams.
  • Comfortable using multiple browser tabs and portals, pdf tools, Excel
  • Track record of maintaining accuracy and organization

Work Location
  • Hybrid work set up
  • Monday to Friday 11PM-8AM
  • Should have strong internet connection (minimum of 20 mbps)
  • Should have own Laptop/PC (minimum of i5 8GB RAM)
Note: As part of our recruitment process, we conduct a background check on all hired candidates. Please ensure that all required documents are prepared and submitted promptly.
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