Medical Biller (full time)

Job Summary

We are seeking a detail-oriented and customer-focused Medical Biller to join our Patient Accounting team. This role involves billing patient accounts to insurance companies or payors efficiently, accurately, and promptly, in compliance with regulations. The ideal candidate will also assist patients, families, and external partners professionally and courteously. This role focuses on Medicare billing and compliance, which plays a critical role in the financial stability of the hospital. Medicare billing requires specialized training (which will be provided, if needed) and strict adherence to regulatory guidelines. Candidates must have the ability to process government insurance claims accurately and efficiently.

Key Job Duties and Responsibilities

Daily Responsibilities:

• Adheres to AIDET principles and HIPAA regulations.

• Verifies insurance, demographic information, and patient eligibility.

• Processes and submits Facility & Professional claims, including primary, secondary, and tertiary insurance.

• Reviews Explanation of Benefits (EOBs), manages denials, and follows up on aging accounts.

• Resolves claim edits, ensures accurate billing, and maintains detailed financial records.

• Coordinates with coding for clarification and processes insurance requests.

• Answers and returns patient and insurance carrier inquiries.

• Performs other duties as assigned.

Job Requirements

Required Education and Licenses: none

Required Work Experience:

• Proficiency in Microsoft Excel, email composition, business correspondence, and general office skills is required.
• Knowledge of basic office functions, including message-taking, cash drawer balancing, and data entry.
• Strong attention to detail, ability to follow directions, and excellent customer service skills in an office environment.
• Experience in an office setting and / or medical billing experience.

Required Knowledge, Skills, and Abilities:

• Exceptional customer service, written and verbal communication skills.
• Positive attitude and commitment to the organization’s values and behavioral standards.
• Ability to work collaboratively, exceed expectations, and maintain a professional demeanor.
• Strong problem-solving and critical thinking skills.
• Proficiency with computer systems and multi-line phone systems.
• Adaptability to changing workflows and situations.

Preferred Qualifications:

• Education or experience in medical office work, referrals, or billing strongly preferred.

Functional Demands

Population(s) Served:
This role serves diverse populations, including neonatal, pediatric, adolescent, adult, and geriatric patients, as well as individuals of varying genders, races, ethnicities, abilities, and socioeconomic backgrounds.

Physical Demands:

• Fast-paced office environment requiring multitasking and prioritization.
• Light lifting (<35 lbs.), bending, kneeling, twisting, and reaching.
• Prolonged periods of sitting, standing, and typing.
• Visual and auditory acuity required for effective communication and task completion.

Environmental Conditions:

• Primarily indoors with some exposure to outdoor elements (e.g., snow/ice when entering/exiting).
• Potential exposure to germs and viruses due to public interactions.