Medical Coder & Biller (Nursing Graduate)

Schedule: 8 HRS plus 1 HR non-paid break

Salary Range: Php40,000-50,000/month

We are looking for an experienced Medical Coder & Biller who can accurately read and interpret medical records, process U.S. healthcare claims, and review medical bills against provider estimates, approved procedures, and final charges. A graduate of a medical-related course is preferred.

• Request, review, and validate medical bills and records from healthcare providers.
• Read and interpret medical records, including diagnoses, procedures, treatments, and clinical documentation.
• Review provider estimates and approved procedures against final medical bills.
• Identify billing discrepancies, coding errors, missing documentation, and inconsistencies.
• Assign, verify, and apply appropriate ICD-10, CPT, and HCPCS codes .
• Prepare and submit accurate claims to private insurers, Medicare, and Medicaid.
• Verify patient eligibility, insurance coverage, benefits, and authorization requirements.
• Monitor and follow up on unpaid, delayed, denied, or rejected claims.
• Investigate claim denials, identify the root cause, make necessary corrections, and resubmit claims.
• Post payments, adjustments, and denials accurately in the billing system.
• Communicate with insurance companies and healthcare providers to resolve billing and claims issues.
• Maintain accurate, complete, and HIPAA-compliant medical billing and claims documentation.
• Prepare claim status, billing, accounts receivable, and collection reports.

• Proven experience in U.S. medical coding, medical billing, claims processing, or revenue cycle management (RCM) .
• Strong ability to read, interpret, and understand medical records and clinical documentation.
• Experience reviewing and verifying medical bills, provider estimates, authorizations, and final charges.
• Ability to identify discrepancies between medical records, approved procedures, and billed services .
• Strong knowledge of medical terminology, diagnoses, procedures, and treatment workflows.
• Proficiency in ICD-10, CPT, and HCPCS coding .
• Knowledge of U.S. healthcare insurance, claims processing, and payer requirements.
• Familiarity with HIPAA regulations and handling confidential patient information.
• Strong attention to detail, analytical, organizational, and problem-solving skills.
• Graduate of a medical-related course is preferred.
• Experience with U.S. healthcare accounts, billing software, EHR/EMR, or practice management systems is an advantage.