Job Description
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 a...