ISTA Solutions, an outsourcing/offshoring company, is in search of an experienced Medical Billing Specialist to join our rapidly expanding team. As a member of our team, you will have the opportunity to work with highly skilled professionals, who prioritize employee satisfaction and work-life balance. At ISTA Solutions, we pride ourselves on creating a culture focused on long-term success and life-long learning. We're looking for a team player who is ready to contribute to our mission, just like you!

Account specific roles & responsibilities:

• Manage the end-to-end medical billing process, including claim preparation, submission, tracking, and follow-up.
• Review patient information, billing records, and supporting documentation to ensure claims are accurate and complete.
• Submit medical claims to HMOs, insurance providers, and other relevant payers in accordance with established guidelines.
• Monitor claim statuses and conduct timely follow-ups on pending, delayed, rejected, or denied claims.
• Investigate claim denials, identify root causes, and coordinate necessary corrections, resubmissions, or appeals.
• Perform cash posting and accurately record payments, adjustments, and other billing transactions.
• Reconcile payments against submitted claims and investigate discrepancies or underpayments.
• Maintain accurate and organized billing records and documentation.
• Coordinate with internal teams and relevant stakeholders to resolve billing issues and support timely reimbursement.
• Ensure compliance with applicable billing requirements, payer guidelines, and internal procedures.
• Monitor outstanding claims and accounts receivable to help minimize payment delays and maintain an efficient revenue cycle.

Requirements

• At least 6 months BPO experience handling US Healthcare account

• Good Working knowledge with HMO Billing (Claims, Denials, Cash Postings)
• Knowledge on Revenue Cycle Management/ Accounts Receivable is a PLUS
• Excellent written and verbal English communication skills
• Amenable to work onsite in Shaw Blvd, Mandaluyong
• Willing to work night shifts

Benefits

What can we offer you?

• Competitive salary and benefits
• Health Insurance with free dependents*
• 10%-night differential
• Attendance Bonus
• Paid time off
• Convertible to cash leave credits
• Performance Appraisal
• Work-life balance
• A focus on growing your career path with us
• We encourage you to follow your passions and learn new skills

Our commitment to you

• Strong culture and values-driven leadership
• We create opportunities for you to learn and grow at any stage of your career
• Continuous learning and innovation
• We foster an all inclusive environment where everyone thrives