Position Summary Power Health Colorado (PHCO) is seeking a
highly experienced Medical Biller with strong knowledge of
personal injury (PI), workers' compensation (WC), and commercial insurance billing. This role is critical to maintaining healthy revenue cycle performance and requires someone who is detail-oriented, accountable, and confident managing claims from submission through resolution.
The ideal candidate understands the nuances of med-legal billing, payer follow-up, and denial management, and can work collaboratively with case managers, front office, and clinical teams to ensure clean claims and timely reimbursement.Key ResponsibilitiesBilling & Claims Management
- Submit accurate and timely medical claims (electronic and paper)
- Ensure proper CPT, ICD-10, and modifier usage
- Review documentation to confirm billing compliance
- Manage billing for PI, WC, and commercial insurance cases
- Handle lien-based and med-legal billing workflows when applicable
Accounts Receivable (A/R) Follow-Up - Conduct proactive follow-up on unpaid or denied claims
- Identify root causes of denials and implement corrective actions
- Work aging reports and prioritize high-value claims
- Maintain clear documentation of payer communications
Denial Management - Analyze denials and prepare appeals
- Coordinate with providers and case managers for required documentation
- Track trends and report recurring issues
Payment Posting - Accurately post insurance and patient payments
- Reconcile EOBs and ERAs
- Identify underpayments and escalate when needed
Collaboration & Accountability - Work closely with case management and front office to reduce billing errors
- Communicate clearly about missing information or documentation gaps
- Participate in team meetings and performance improvement initiatives
- Maintain HIPAA compliance and confidentiality at all times
QualificationsRequired
- 3+ years of medical billing experience
- Strong knowledge of CPT, ICD-10, HCPCS coding
- Experience with PI and/or workers' compensation billing
- Proficiency in EHR/PM systems (e.g., eClinicalWorks or similar)
- Strong A/R follow-up and denial resolution skills
- High attention to detail and accuracy
- Professional communication skills
Preferred - Experience in multi-disciplinary practices (PT, Chiro, PM&R, etc.)
- Familiarity with lien-based billing models
- Certification (CPB, CPC, or similar)
- Performance-driven mindset with measurable productivity standards
Success Metrics (KPIs) - A/R days within target range
- Clean claim rate
- Denial rate reduction
- Timely follow-up productivity benchmarks
- Accurate payment posting rate
What We Value at PHCO - Accountability over excuses
- Team-first mindset
- Continuous improvement
- Patient-centered approach
- Integrity and professionalism
Compensation & Benefits - Competitive pay based on experience
- Benefits package (if applicable)
- Growth opportunities within PHCO