Medical Biller (hybrid)

Position Overview:

We seek a detail-oriented and organized Medical Biller to join our healthcare team. The Medical Biller will play a crucial role in ensuring the accurate and timely submission of medical claims to insurance companies, government programs, and patients. The ideal candidate should have a strong understanding of medical billing processes, insurance regulations, and reimbursement procedures to facilitate efficient revenue cycle management.

Responsibilities:

• Review and verify patient demographics, insurance information, and medical documentation to accurately generate and submit medical claims for services provided.
• Utilize coding knowledge to validate and match procedure and diagnosis codes, modifiers, and other relevant information on claims forms.
• Coordinate with medical coders and healthcare providers to ensure accurate translation of medical services into billable codes.
• Verify insurance coverage and patient eligibility, and communicate with insurance companies to resolve claim issues or discrepancies.
• Follow up on unpaid or denied claims, including investigating reasons for denials, resubmitting corrected claims, and appealing denied claims when necessary. To ensure compliant billing practices, maintain a thorough understanding of insurance regulations, including Medicare, Medicaid, and private insurance policies.
• Collaborate with patients to provide clear and accurate explanations of billing statements, payment options, and any potential financial assistance programs.
• Generate and distribute patient invoices for services not covered by insurance, and track patient payments and outstanding balances.
• Maintain accurate and up-to-date billing records and documentation, ensuring proper coding, billing, and audit trails.
• Coordinate with internal departments, including coding, medical records, and finance, to streamline billing processes and resolve billing-related inquiries.
• Stay current with changes in medical billing regulations, codes, and industry trends to ensure accurate and compliant billing practices.
• Participate in training and educational programs to enhance billing knowledge and maintain industry certifications.
• Provide support during audits and ensure compliance with billing and documentation standards.
• Collaborate with IT teams to ensure the integration of billing data into electronic health record (EHR) systems.

Qualifications:

• High school diploma or equivalent; associate’s degree in Health Information Management or related field preferred.
• Certified Professional Biller (CPB) credential from AAPC or Certified Billing Specialist (CBS) credential from AHIMA is highly preferred.
• Minimum of 2 years of experience in medical billing, preferably in a healthcare or medical office setting.
• Strong knowledge of medical billing processes, insurance regulations, and reimbursement procedures.
• Familiarity with medical coding and terminology to effectively communicate with coding teams.
• Proficiency in using billing software, practice management systems, and electronic health records (EHR).
• Attention to detail and ability to maintain accuracy in a fast-paced environment.
• Strong analytical and problem-solving skills.
• Excellent communication and interpersonal skills to effectively interact with patients, insurance representatives, and colleagues.
• Commitment to maintaining patient confidentiality and adhering to HIPAA regulations.
• Ability to adapt to changes in billing guidelines and industry regulations.
• Strong organizational skills and ability to manage time effectively.
• Knowledge of revenue cycle management and accounts receivable processes is a plus.
• Compensation:
• The compensation package will be commensurate with experience and qualifications.