We are seeking a detail-oriented and experienced Medical Biller to join our private hospital team. The ideal candidate must have experience in doing medical billing and coding for accurate and timely submission of claims to various payers (Insurance, Government, Corporations and Individuals) ensuring maximum reimbursement while maintaining strict compliance with healthcare regulations and hospital policies.

KEY RESPONSIBILITIES

1. Claims Management & Submission

• Prepare and submit (using ICD 10/ICD11 and CPT codes) accurate medical claims to insurance companies (DHA/HAAD/DOH, TPA’s, and International Insurers).
• Verify patient insurance eligibility and benefits prior to admission or procedure scheduling.
• Ensure all ICD-10/ICD-11 and CPT/HCPCS coding is accurate prior to submission.

2. Payment Posting & Reconciliation

• Post insurance and patient payments accurately into the hospital information system.
• Reconcile daily collections and prepare deposit slips.
• Identify and correct discrepancies in payments vs. contractual agreements.

3. Denial Management & Follow-up

• Review and analyze denied claims; identify root causes and resubmit corrected claims within the payer’s timely filing limits.
• Appeal complex denied claims through written appeals and phone calls.
• Work with the Accounts Receivable (A/R) aging report to reduce outstanding days.

4. Patient Billing & Customer Service

• Generate and send patient statements for co-payments, deductibles, or self-pay balances.
• Handle patient inquiries regarding billing statements, insurance coverage, and payment plans with empathy and professionalism.
• Maintain patient confidentiality in accordance with HIPAA/local data protection laws.

5. Compliance & Reporting

• Ensure all billing practices comply with local health authority regulations
• Assist with internal and external audits by providing necessary documentation.
• Stay updated on changes in coding guidelines, payer policies, and healthcare regulations.