Medical Biller

The ideal candidate will be responsible for accurately and efficiently processing medical claims and invoices, ensuring timely reimbursement from insurance companies and patients. The Medical Biller will work closely with healthcare providers, insurance companies, and patients to resolve billing discrepancies and ensure compliance with regulatory requirements.

Responsibilities:

Claims Processing: Prepare and submit accurate medical claims to insurance companies, Medicare, and Medicaid for reimbursement.
Billing: Generate and send invoices to patients for services rendered, following up on outstanding balances and resolving billing discrepancies.
Insurance Verification: Verify patients’ insurance coverage and eligibility, ensuring all necessary authorizations and referrals are obtained prior to services being rendered.
Coding: Assign appropriate medical codes (ICD-10, CPT, HCPCS) to diagnoses and procedures for billing purposes, ensuring compliance with coding guidelines and regulations.
Payment Posting: Record and reconcile payments received from insurance companies and patients, applying them to the appropriate accounts in the billing system.
Denial Management: Investigate and appeal claim denials and rejections, identifying and addressing root causes to prevent future issues.
Patient Communication: Communicate with patients regarding billing inquiries, payment plans, and financial assistance options, providing excellent customer service while resolving concerns.
Documentation: Maintain accurate and up-to-date records of billing activities, including claims submissions, payments, and correspondence with insurance companies and patients.
Compliance: Adhere to all relevant healthcare regulations, including HIPAA and billing compliance guidelines, to ensure the integrity and confidentiality of patient information.

Requirements:

Education: High school diploma or equivalent required; additional certification in medical billing and coding preferred.
Experience: Minimum of one year of experience in medical billing, preferably in a healthcare setting.
Knowledge: Proficient in medical terminology, billing software (e.g., Epic, Cerner), and insurance claim processing procedures.
Skills: Strong attention to detail, excellent organizational and time management skills, and the ability to multitask in a fast-paced environment.
Communication: Effective verbal and written communication skills, with the ability to interact professionally with patients, providers, and insurance representatives.
Problem-Solving: Demonstrated ability to analyze billing issues, identify solutions, and implement process improvements to optimize revenue cycle management.
Teamwork: Ability to collaborate with colleagues across departments to resolve billing-related issues and achieve organizational goals.

System Requirements:

At least 15mbps for main internet and at least 10mbps for backup
A desktop or laptop that has an i5 processor with at least 8 GB RAM and an i3 processor for backup
Note: Back-ups should still be able to function when there is a power interruption
A webcam
Noise-canceling USB Headset
Quiet, Dedicated Home Office