Medical Biller

Job Description

About the Role:

We are seeking a detail-oriented and highly organized Medical Biller to join our growing team. In this role, you will be responsible for managing the full medical billing lifecycle: from eligibility verification and claim submission to payment posting and follow-up, while providing excellent service to both patients and internal stakeholders. This is a great opportunity for someone who thrives in a collaborative, fast-paced environment and takes pride in accuracy, compliance, and patient advocacy.

Key Responsibilities:

• Verify patient insurance eligibility and benefits

• Review medical coding prior to claim submission to ensure accuracy and compliance

• Prepare, review, and submit medical claims using billing software, including both electronic and paper claims

• Review patient invoices for accuracy

• Follow up on unpaid or underpaid claims within designated timeframes

• Review insurance payments for accuracy and compliance with payer contracts

• Contact insurance companies to resolve payment discrepancies when needed

• Identify and submit claims to secondary and tertiary insurance carriers

• Review accounts for insurance and patient follow-up

• Research, appeal, and resolve denied or rejected claims in a timely manner

• Respond to patient and insurance inquiries related to assigned accounts via phone

• Set up patient payment plans and manage collection accounts as appropriate

• Monitor assigned accounts to ensure appropriate and timely reimbursement

• Communicate effectively with clients, internal support staff, and account managers as needed

• Maintain strict patient confidentiality in accordance with HIPAA regulations

Minimum Qualifications:

• High school diploma or equivalent

• Experience with medical billing and claims processing

• Competency in outpatient and inpatient medical coding

• Working knowledge of CPT and ICD-10 coding

• Familiarity with insurance guidelines, including HMO/PPO plans, Medicare (MIPS/MACRA), Medicaid, and other payer requirements

• Proficiency with computer systems and electronic medical billing software

• Strong verbal and written communication skills

• Ability to multitask, prioritize work, and manage time effectively

• Strong problem-solving skills and attention to detail

• Ability to work collaboratively in a team environment

• Knowledge of medical terminology commonly used in medical billing

• Commitment to maintaining patient confidentiality in compliance with HIPAA

Preferred Qualifications: 

• Experience with E-Clinical and Tebra

• Prior experience communicating directly with insurance payers to resolve discrepancies

• Customer service experience working directly with patients and families

• Experience setting up patient payment plans and managing collections

• Demonstrated ability to research, appeal, and resolve denied or rejected claims

• Experience working in a remote or fast-paced healthcare environment

• Commitment to continuing education and staying current with billing and coding updates

Job Type: Full-time 

Benefits: 

• Flexible schedule
• Paid time off
• Health Insurance
• 401K Matching

Schedule: 

• Monday to Friday

Work Location: Remote