Medical Biller

Job Summary
At North Jersey Therapy Center (NJTC), we are seeking a Medical Biller to help manage the accurate and timely submission of medical claims for services provided in a specialized practice focused on respiratory and sleep studies, physical therapy, and cardiopulmonary diagnostics. This role involves verifying patient insurance coverage, coding medical procedures and diagnoses in accordance with current CPT, HCPCS, and ICD-10 guidelines, and ensuring proper documentation to support claim reimbursement. The Medical Biller works closely with clinical staff, administrative personnel, and insurance providers to resolve billing issues, process denials, and follow up on outstanding claims. Knowledge of payer-specific guidelines, including Medicare and commercial insurance policies related to respiratory therapy, polysomnography, rehabilitation services, and cardiopulmonary testing, is essential. Accuracy, attention to compliance, and effective communication with patients regarding account balances and billing inquiries are critical aspects of this position.

Responsibilities

• Review clinical documentation and assign appropriate CPT, ICD-10, and HCPCS codes according to payer guidelines and compliance standards
• Verify patient insurance eligibility and benefits prior to services being rendered
• Track claim status, follow up on unpaid or denied claims, and resubmit corrected claims as necessary
• Work directly with insurance companies, third-party payers, and patients to resolve billing discrepancies or authorization issues
• Maintain up-to-date knowledge of payer policies, including Medicare and commercial insurance requirements for specialized procedures
• Generate patient statements, process payments, and manage account balances
• Respond to patient inquiries regarding billing statements, insurance coverage, and payment options in a professional and courteous manner
• Collaborate with clinical and front-office staff to ensure complete and accurate billing documentation
• Maintain confidentiality of patient information and ensure compliance with HIPAA and other regulatory standards
• Monitor and report billing trends, denials, and reimbursement patterns to management
• Utilize practice management and billing software systems efficiently for data entry, claims tracking, and reporting

Skills

• Proficiency in medical billing processes and procedures.
• Strong knowledge of ICD coding (ICD-9, ICD-10) and CPT coding standards.
• Familiarity with DRG classifications and their application in billing.
• Experience with medical collections and accounts receivable management.
• Solid understanding of medical terminology and healthcare practices.
• Previous experience in a medical office setting is preferred.
• Ability to work efficiently with EMR and EHR systems for accurate record keeping.
• Excellent attention to detail, organizational skills, and ability to multitask effectively.

Job Type: Full-time

Pay: $19.00 - $24.00 per hour

Benefits:

• Dental insurance
• Health insurance
• Paid time off
• Retirement plan
• Vision insurance

Ability to Commute:

• Wayne, NJ 07470 (Required)

Ability to Relocate:

• Wayne, NJ 07470: Relocate before starting work (Required)

Work Location: In person

Salary : $19 - $24