Medical Representative Philippines jobs

Shift: Monday - Friday, 10:30 PM - 7:30 AM Philippine Time

Rate: Php40,000 - 45,000/monthly

Medical Billing & Claims Management

Billing Preparation & Submission

Prepare, review, and submit accurate medical claims to insurance companies (private, Medicare, Medicaid) using ICD-10, CPT, and HCPCS codes.

Insurance Verification

Verify patient insurance coverage, eligibility, and benefits to ensure accurate billing and prevent claim denials.

Claims Tracking & Follow-Up

Monitor submitted claims, track statuses, and follow up on unpaid, denied, or rejected claims to ensure timely reimbursement.

Denial Management

Identify reasons for claim denials, correct errors, gather missing documentation, and resubmit claims as needed.

Payment Posting

Accurately post payments, adjustments, and rejections to patient accounts while maintaining clean financial records.

Compliance & Documentation

Ensure all billing activities comply with U.S. healthcare regulations, including HIPAA, payer-specific guidelines, and coding standards.

Reporting

Generate billing, collection, and claims-tracking reports to help improve revenue cycle efficiency.

Qualifications

Medical Knowledge
Strong understanding of medical terminology, common diagnoses, procedures, and treatment workflows (no clinical background required).

U.S. Healthcare & Billing Experience
Proven experience in U.S. medical billing, claims processing, or revenue cycle management.
Must be proficient with ICD-10, CPT, and HCPCS coding and familiar with HIPAA regulations.

Billing Systems Expertise
Hands-on experience using medical billing software, EMR/EHR systems, and insurance portals.

Claims & Coding Accuracy
High attention to detail with the ability to identify coding errors, documentation gaps, and inconsistencies in claims.

Problem-Solving & Denial Management
Ability to research, analyze, and resolve denied or unpaid claims and handle follow-ups with insurers.

Soft Skills
Organized, analytical, and able to manage high volumes of data efficiently.
Professional and confident communicating with insurance representatives, healthcare providers, and internal teams.

Communication Skills
Excellent written and verbal English communication skills, especially in explaining billing issues and coordinating claim resolutions.

Job Type: Permanent

Pay: Php40,000.00 - Php50,000.00 per month

Work Location: Remote