# Medical Billing Team Lead | US HMO | Get a 21K Signing Bonus

> ISTA Personnel Solutions · Makati, Philippines · Full-time · Posted 2026-07-07

**Workplace:** on_site

**Department:** Quality Healthcare Resources

## Description

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:**

SNF Billing

-   Process and submit claims for Skilled Nursing Facility (SNF) services.
-   Bill Medicare Part A, Medicare Part B, Medicaid, Managed Care, HMO, and commercial insurance.
-   Review patient census, admission, discharge, and payer information for billing accuracy.
-   Verify patient eligibility, insurance coverage, authorizations, and benefit periods.
-   Ensure compliance with Medicare SNF billing regulations and CMS guidelines.
-   Monitor consolidated billing requirements and identify excluded services when applicable.

HMO Billing

-   Submit and manage HMO claims according to payer-specific requirements.
-   Verify referrals, prior authorizations, and eligibility.
-   Resolve HMO claim edits, rejections, and denials.
-   Ensure timely filing and compliance with individual payer guidelines.
-   Claims Processing
-   Prepare, review, and submit clean claims electronically.
-   Correct rejected claims and resubmit promptly.
-   Monitor claim status through clearinghouses and payer portals.
-   Maintain claim accuracy to maximize first-pass acceptance.
-   Accounts Receivable (AR) Management
-   Perform insurance follow-up on unpaid and underpaid claims.
-   Research outstanding balances and payment discrepancies.
-   Contact insurance companies regarding claim status and reimbursement.
-   Escalate unresolved billing issues when necessary.

Payment Posting

-   Post insurance payments, contractual adjustments, patient payments, and denials accurately.
-   Reconcile Electronic Remittance Advice (ERA) and Explanation of Benefits (EOB).
-   Identify payment variances and investigate underpayments.
-   Denial Management
-   Analyze denied claims to determine root causes.
-   Prepare and submit corrected claims, appeals, and reconsiderations.
-   Track appeal outcomes and maintain documentation.
-   Compliance & Documentation
-   Maintain HIPAA compliance and patient confidentiality.
-   Follow CMS, Medicare, Medicaid, and payer-specific billing regulations.
-   Document all billing activities thoroughly within the billing system.
-   Stay updated on changes to reimbursement policies and billing requirements.

**Job Description:** 

-   Provides customer support through different communication channels (Phone, email, chat). 
-   Resolve issues & accommodate customer inquiries to ensure satisfaction with products or services. 
-   Collaborate with colleagues and different departments to resolve complex issues 
-   Maintain accurate records on customer interactions, transaction, feedback, etc.

## Requirements

-   Minimum 2 years of BPO U.S. Medical Billing experience.
-   At least 1 year of dedicated SNF (Skilled Nursing Facility) billing experience.
-   Experience billing HMO, Medicare, Medicaid, Managed Care, and Commercial Insurance.
-   Strong knowledge of:

-   Medicare Part A
-   Medicare Part B

-   Medicaid
-   Skilled Nursing Facility reimbursement
-   Managed Care plans
-   Coordination of Benefits (COB)
-   Accounts Receivable follow-up
-   Denial Management
-   Appeals Process
-   Electronic Claims Submission

-   Excellent verbal and written English skills
-   Willing to work onsite in Buendia, Makati
-   Amenable working night shift

## 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

## Apply

[Apply at ISTA Personnel Solutions](https://apply.workable.com/ista-2/j/CCE4C5BA67/apply)

---
Powered by [Workable](https://www.workable.com)