Medical Biller

Description

• Review and enter patient demographic, insurance, procedure, diagnosis, and charge data accurately into the billing system.
• Validate coding accuracy using ICD-10, CPT, and HCPCS guidelines.
• Prepare and submit clean claims to Medicare, Medicaid, and commercial insurance carriers.
• Monitor claim status through payer portals and clearinghouses.
• Identify, research, and resolve claim denials, rejections, and underpayments.
• Prepare and submit claim corrections and appeals within payer deadlines.
• Post insurance payments, patient payments, contractual adjustments, refunds, and write-offs.
• Generate patient statements and respond to billing inquiries professionally.
• Establish and manage payment plans for self-pay and delinquent accounts.
• Verify insurance eligibility, benefits, and authorizations as needed.
• Maintain accurate documentation of billing activity and correspondence.
• Ensure compliance with HIPAA, payer contracts, and internal policies.
• Collaborate with providers, coding staff, and front-office personnel to resolve documentation or billing discrepancies.

Requirements

• High school diploma or GED required.
• 1-3 years of medical billing experience preferred.
• Certification such as CPB, CPC, or equivalent is preferred but not required.
• Strong knowledge of medical billing processes and revenue cycle management.
• Proficiency in ICD-10, CPT, and HCPCS coding standards.
• Experience working with EHR/EMR systems, billing software, and clearinghouses.
• Familiarity with Medicare, Medicaid, and commercial insurance guidelines.
• Ability to analyze EOBs, remittance advice, and denial codes.
• High attention to detail and strong organizational skills.
• Ability to maintain confidentiality and comply with HIPAA regulations.
• Professional communication skills for patient and insurance interactions.