Medical Biller

We are seeking a skilled Medical Biller with 2 to 4 years of experience in US medical billing to join our Revenue Cycle Management team based in Islamabad, Pakistan. The successful candidate will play a vital role in managing the complete revenue cycle process for healthcare providers, ensuring accurate and timely billing. This position requires hands-on experience with insurance claims, accounts receivable, denial management, and payer follow-up, along with a strong understanding of US healthcare billing practices.

Key Responsibilities
- Review and process medical claims accurately and promptly.
- Perform charge entry, verifying patient, provider, insurance, and service details.
- Submit electronic and paper claims to insurance companies as needed.
- Examine claims for errors, missing information, incorrect coding, and payer-specific requirements before submission.
- Follow up with insurance companies on outstanding and unpaid claims.
- Manage denials, rejections, and claim corrections by identifying reasons and implementing corrective actions.
- Handle Accounts Receivable (AR) and pursue aging claims to ensure timely reimbursement.
- Post insurance and patient payments accurately and reconcile payment records.
- Review Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs), addressing underpayments, denials, and adjustments.
- Verify patient insurance eligibility and benefits when required.
- Collaborate with coding, clinical, and internal billing teams to resolve claim-related issues.
- Maintain accurate records of claims, follow-ups, denials, payments, and outstanding balances.
- Communicate with insurance representatives regarding claim status, eligibility, benefits, and reimbursement concerns.
- Identify recurring billing issues and report them for resolution.
- Ensure confidentiality of patient information in compliance with HIPAA and relevant healthcare regulations.
- Achieve assigned productivity, quality, collection, and turnaround-time targets.

Required Qualifications
- 2 to 4 years of experience in US medical billing and Revenue Cycle Management (RCM).
- Strong understanding of the US healthcare revenue cycle.
- Practical experience with claims submission, AR follow-up, denial management, and payment posting.
- Familiarity with EOBs, ERAs, CPT, HCPCS, ICD-10, and modifiers.
- Knowledge of major US insurance payers and their billing requirements.
- Experience working with medical billing/RCM software and clearinghouses.
- Good written and verbal communication skills.
- Strong attention to detail with the ability to identify billing discrepancies.
- Analytical and problem-solving skills.
- Ability to manage multiple accounts and meet deadlines.
- Proficiency in MS Office, particularly Excel, is preferred.

Preferred Qualifications and Benefits
- Experience with US physician billing or professional billing.
- Familiarity with Medicare, Medicaid, and commercial insurance payers.
- Proven track record in denial and rejection resolution.
- Knowledge of HIPAA compliance standards.
- Experience using healthcare RCM platforms, Electronic Health Records (EHRs), Practice Management (PM) systems, and clearinghouses.
- Relevant medical billing certifications such as CPC, CPB, or similar credentials are a plus.

This role offers the opportunity to contribute to a dynamic team focused on optimizing revenue cycle processes while maintaining compliance and high-quality standards. Candidates who demonstrate accuracy, efficiency, and a proactive approach to billing challenges will thrive in this position.