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    • Strong understanding of medical billing workflows, claim submission, and coding fundamentals.
    • Maintain accurate billing records and claim documentation.
    • View all Alpaca Health jobs - Philippines jobs - Medical Biller jobs in Philippines
    • Salary Search: Medical Billing Specialist (Claim Submission) salaries in Philippines
    • A medical/allied medical science or legal background would be an advantage.
    • Appraises and approves claims within prescribed approval limits, performs initial…
    • Strong understanding of the medical billing revenue cycle.
    • Communicate with insurance representatives regarding claim status and reimbursement.
    • Assist in building and refining eCW’s claim AI, creating prompts and patterns to automate claim review and reduce manual workload (approx. 500 claims per week).
    • 2+ years of experience working closely with US healthcare claims or in a claims processing/adjudication environment.
    • Work Setup: In‑Office Training Required.
    • Proven experience in U.S. medical coding, medical billing, claims processing, or revenue cycle management (RCM).
    • Medical Plan (HMO) from Day 1 of employment with free dependents.
    • Review, analyze, and resolve denied medical claims.
    • Manage and work assigned physician insurance claims.
    • Monitor claim status until final payment or resolution.
    • Maintain clear, complete, and audit-ready claim notes to support all claim decisions.
    • Medicare and Medi-Cal claims processing.
    • Submit medical claims accurately and efficiently to insurance payers.
    • You will spend the majority of your day submitting medical claims, following up with…
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    • At least a High School Graduate.

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Job Post Details

Medical Billing Specialist (Claim Submission) - job post

Alpaca Health
4.4 out of 5 stars
Philippines•Remote

Job details

Job type

  • Full-time

Full job description

About Alpaca Health

Alpaca Health enables clinicians to become entrepreneurs, starting in autism care.

We help clinicians launch and scale their own clinics by providing AI-powered software, payer contracting, and full back-office infrastructure. Our goal is simple: shift power in healthcare away from large consolidated entities and back to clinicians.

This role is remote. We’re looking for candidates based outside of the United States, but able to work United States East Coast time zones.

What You’ll Do

We are looking for a detail-oriented Billing Specialist to own pre-submission billing accuracy and ensure clean claims are submitted correctly the first time. This role focuses on resolving coding issues, identifying EHR and demographic inaccuracies, and preventing downstream denials and rework. Specifically, this role will:

  • Review claims prior to submission to identify coding, demographic, and documentation issues

  • Own pre-submission billing edits and claim scrubbing workflows

  • Resolve coding-related issues including CPT modifiers, diagnosis mismatches, and authorization discrepancies

  • Review EHR data for demographic accuracy, insurance information, rendering provider setup, and payer requirements

  • Identify and correct missing or inaccurate patient, provider, or authorization data before claims submission

  • Coordinate with clinical, intake, credentialing, and operations teams to resolve billing blockers

  • Monitor clearinghouse rejections and ensure timely corrections and resubmissions

  • Maintain accurate billing records and claim documentation

  • Support process improvement initiatives to reduce preventable denials and increase clean claim rates

  • Assist with payer and clearinghouse communication via portal, fax, phone, and email

  • Track recurring claim issues and escalate systemic problems proactively

Who You Are

  • Bachelor’s degree or equivalent experience

  • Excellent attention to detail and organizational skills

  • At least 2–3 years of experience in healthcare billing or revenue cycle operations

  • Strong understanding of medical billing workflows, claim submission, and coding fundamentals

  • Experience working with EHR systems, clearinghouses, and billing platforms

  • Familiarity with commercial and government insurance requirements

  • Strong communication and problem-solving abilities

  • Comfortable working cross-functionally with clinical and operational teams

  • Proficient in MS Office and business systems

  • Ability to manage multiple priorities and meet deadlines in a fast-paced environment

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