Medical Biller

Job Summary

We are seeking a detail-oriented and experienced Medical Biller to join our healthcare team. The Medical Biller is responsible for preparing and submitting patient claims to insurance companies, following up on unpaid accounts, and ensuring accurate billing to maximize reimbursement and support the revenue cycle.

Key Responsibilities

• Prepare, review, and submit medical claims to private and government payers (Medicare, Medicaid, commercial insurers).

• Verify patient insurance eligibility and benefits prior to claim submission.

• Follow up on denied or unpaid claims and initiate appeals or corrections as needed.

• Post payments from insurers and patients accurately into the billing system.

• Resolve billing discrepancies and respond to inquiries from insurance providers and patients.

• Collaborate with clinical and administrative staff to clarify documentation and coding issues.

• Ensure compliance with HIPAA regulations and maintain confidentiality of patient information.

• Maintain up-to-date knowledge of payer rules, billing procedures, and coding guidelines (ICD-10, CPT, HCPCS).

Qualifications

• High school diploma or GED required; Associate’s degree or certification in medical billing/coding preferred.

• Minimum 1–2 years of experience in medical billing, preferably in a clinical or hospital setting.

• Proficiency in billing software (e.g., Epic, Kareo, NextGen, AdvancedMD, or equivalent).

• Strong understanding of EOBs, claim forms (CMS-1500/UB-04), and payer requirements.

• Excellent organizational and communication skills.

• Knowledge of ICD-10, CPT, and HCPCS codes.