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Open nowPosted 246 days ago

Home Health Medical Billing Specialist

Pointwest13 open roles

Where
Quezon City, Philippines
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Your applicationOpen nowHome Health Medical Billing SpecialistPointwest · Quezon City, Philippines

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The clock on this job

Early applications get read.

12.3% of postings close within 7 days. Measured by our own scanner across the market.

Share of postings closed within
  1. 2.1%1 day
  2. 4.5%3 days
  3. 12.3%7 days
  4. 19.3%14 days
  5. 35.6%30 days
  6. 58.1%60 days
This job: posted 246 days ago

The posting

We are seeking a detail-oriented Medical Billing Specialist based in Manila to support US-based home health agencies. The ideal candidate will have hands-on experience in processing claims under Medicare, Medicaid, and commercial payers with a strong grasp of PDGM, OASIS, and HIPPS codes. This role is crucial to ensuring timely and accurate revenue cycle performance in accordance with US home health billing standards.

Key Responsibilities:

  • Review and validate clinical and administrative documentation (e.g., OASIS, Plan of Care, Face-to-Face documentation) before billing.
  • Accurately generate and submit RAPs, Final Claims, NOAs (Notice of Admission), and NOEs (Notice of Election) through Medicare DDE, clearinghouses, or EHR systems (e.g., Kinnser, WellSky, Axxess, HCHB).
  • Assign appropriate HIPPS codes and billing modifiers based on clinical inputs and assessments.
  • Track and follow up on unpaid or denied claims; initiate appeals and resubmissions as necessary.
  • Maintain AR follow-up and timely posting of payments, adjustments, and write-offs.
  • Communicate proactively with US-based teams (Billing, Clinical, QA) to resolve claim issues.
  • Stay current with CMS and payer-specific updates impacting home health billing.
  • Ensure all processes comply with HIPAA and data security standards.

Qualifications:

Education: College graduate (with preference for medical or business-related courses).

Experience: Minimum 1 year of experience in US home health billing.

Technical Skills:

  • Familiar with Medicare billing guidelines and the PDGM model.
  • Proficient in home health EMRs (e.g., WellSky, Kinnser, Axxess, HCHB).
  • Experience using DDE/FISS and/or medical billing clearinghouses.
  • Working knowledge of HIPPS codes, CPT/HCPCS, and ICD-10.

Soft Skills:

  • Excellent English communication skills (written and spoken).
  • High attention to detail and organizational skills.
  • Ability to work US business hours (Eastern or Central time zones).

Preferred Qualifications:

  • Prior BPO/RPO experience in US healthcare or RCM support.
  • Knowledge of U.S. insurance authorization and eligibility workflows.
  • Certification in medical billing (e.g., AAPC CPB, AMBA CMRS) is a plus.

Work Setup:

  • Schedule: Mixed; Day Shift & Night shift aligned with US time zones (EST/CST preferred).
  • Work Location: 100% Work-in-Office

Tools Provided: HIPAA-compliant equipment and secure internet access required

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