Medical Billing Specialist

This full-time, on-site Medical Billing Specialist position is based in Karachi. The role involves preparing, submitting, and tracking medical claims to insurance companies and government payers while ensuring accuracy and compliance with all relevant billing requirements. The specialist will work closely with healthcare providers and internal teams to resolve billing issues and maintain proper documentation.

Key Responsibilities

- Review patient records, documentation, and ICD-10 codes to ensure accuracy.
- Prepare and submit claims to Medicare and other insurance carriers.
- Review and resolve claim rejections promptly.
- Provide medical records and supporting documentation to insurance companies as requested.
- Accurately post insurance and patient payments, review Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs), and reconcile payments with accounts receivable. Identify underpayments, adjustments, and outstanding patient balances.
- Prepare and send patient statements for any outstanding balances.
- Communicate effectively with healthcare providers and internal team members to clarify documentation, coding, or billing issues.
- Maintain patient confidentiality and comply with applicable data protection and privacy regulations.
- Collaborate with team members to achieve departmental productivity, accuracy, and performance goals.

Required Qualifications

- Proven experience in medical billing, preferably with knowledge of Medicare and other insurance carriers.
- Strong understanding of ICD-10 coding and medical documentation standards.
- Ability to accurately review and process medical claims and payments.
- Familiarity with Explanation of Benefits (EOBs), Electronic Remittance Advices (ERAs), and accounts receivable reconciliation.
- Excellent communication skills to liaise with healthcare providers and internal teams.
- Commitment to maintaining patient confidentiality and adhering to privacy regulations.
- Detail-oriented with strong organizational and problem-solving skills.

Preferred Qualifications and Benefits

While specific preferred qualifications and benefits are not detailed, candidates with prior experience working in a healthcare setting or with government payers will be advantageous. The role offers an opportunity to work in a collaborative environment focused on accuracy and compliance within the medical billing process.

This position requires a dedicated professional who can manage multiple tasks efficiently while maintaining high standards of accuracy and confidentiality.