Remote Medical Biller (RPM/CCM Specialist)

Job Description

About Us:
 
Outsourced.ph is a leading ISO-certified Philippines offshore outsourcing company that provides dedicated remote staff to some of the world's leading international companies. Outsourced is recognized as one of the Best Places to Work and has achieved Great Place to Work Certification. We are committed to providing a positive and supportive work environment where all staff can thrive. As an Outsourced staff member, you will enjoy a fun and friendly working environment, competitive salaries, opportunities for growth and development, work-life balance, and the chance to share your passion with a team of over 1,000 talented professionals.
 
Responsibilities RPM/CCM-Specific Billing

• Submit claims for RPM codes (99453, 99454, 99457, 99458) and CCM codes (99490, 99439, 99487, 99489).
• Validate documentation meets CMS and commercial payer requirements (e.g., 16-day rule, interactive communication, time logs).
• Reconcile patient encounters, time logs, and platform data against billing submissions.
• Track denials or rejections specific to RPM/CCM and resubmit with corrected documentation.
• Provide monthly reports on RPM/CCM revenue performance and outstanding claims.

General Medical Billing

• Process insurance claims for E/M visits, labs, and other services as required by provider offices.
• Verify patient insurance eligibility and benefits before claim submission.
• Post payments, adjustments, and rejections into the billing system/EHR.
• Work accounts receivable (A/R) to reduce outstanding balances and improve cash flow.
• Coordinate with front-office staff and providers on coding, documentation, and claim corrections.

Compliance & Communication

• Stay current with CMS guidelines and payer policy changes for RPM, CCM, and general medical billing.
• Ensure compliance with HIPAA and confidentiality standards.
• Collaborate with offshore and U.S.-based teams (MAs, RNs, providers, operations) to resolve billing issues.
• Maintain detailed records and audit-ready documentation for all claims.

Qualifications

• Minimum 2 years of experience in medical billing and coding, with at least 1 year in RPM/CCM billing.
• Strong knowledge of CPT, HCPCS, and ICD-10 coding standards.
• Familiarity with major U.S. payers (Medicare, Medicaid, commercial insurance).
• Experience with clearinghouses and EHR systems (MDLand, eClinicalWorks, Epic, or similar).
• Strong English communication skills (spoken and written).
• High attention to detail and organizational skills.
• Reliable internet connection and secure remote work setup.

Key Skills

• RPM/CCM reimbursement workflows
• Claims submission and follow-up
• Accounts receivable management
• Denial management and resubmission
• Payer policy interpretation
• Data reconciliation and reporting

 
Work Schedule

• 9:00 PM - 5:00 AM Manila Time

Work Location: 

• Home-based
• Should have a strong internet connection (minimum of 20 MBPS)
• Should have own laptop/pc (minimum of i5 8GB)

Note: As part of our recruitment process, we conduct a background check on all hired candidates. Please ensure that all required documents are prepared and submitted promptly.   By clicking on the "I'm Interested" button I hereby allow Outsourced Quality Assured Services, Inc. ("Outsourced") to store and collect my personal information for the purposes of employment application. As such, I agree and authorize Outsourced to collect, store, or continue to use my personal information for the above-stated purpose, and to retain my personal information for a period of 1 year, and for these purposes only.