Medical Biller

About the Role

Spire Healthcare Management is seeking an experienced Medical Biller to join our billing team. This role is responsible for accurate and timely claims submission, follow-up, and resolution of billing issues, with a strong emphasis on customer service and attention to detail. Experience in DMEPOS (Durable Medical Equipment, Prosthetics, Orthotics, and Supplies) billing is strongly preferred.

Key Responsibilities

• Prepare, review, and submit accurate medical claims to insurance carriers (Medicare, Medicaid, and commercial payers)
• Follow up on unpaid or denied claims, research discrepancies, and resubmit as needed
• Verify insurance eligibility and benefits prior to billing
• Post payments, adjustments, and denials accurately to patient accounts
• Prepare and submit prior authorizations for equipment and services
• Perform accurate data entry related to patient accounts, orders, and billing records
• Process equipment orders and drop shipments
• Confirm order tickets for accuracy and completeness
• Document and maintain accurate records
• Communicate professionally with patients, insurance representatives, physicians and other medical professionals, and internal teams to resolve billing inquiries/patient orders/other insurance and customer issues
• Communicate with customers and families regarding equipment options, delivery schedules, and any additional requirements
• Provide education and instructions on the proper use of equipment
• Maintain compliance with HIPAA and payer-specific billing regulations
• Identify and escalate billing trends, denial patterns, or process gaps
• Support month-end billing reconciliation and reporting as needed

Qualifications

• Minimum 3 years of experience in medical billing and/or customer service within a healthcare setting preferred
• DMEPOS billing experience strongly preferred
• Working knowledge of CPT, HCPCS, and ICD-10 coding
• Familiarity with insurance verification, prior authorizations, and claims appeals
• Strong written and verbal communication skills
• Proficiency with billing software and Microsoft Office (Excel in particular); working knowledge of Brightree, EPIC, Synapse, and Parachute a plus
• Ability to manage a high volume of claims with accuracy and attention to detail
• Associate degree or higher in Business, Healthcare Administration, or a related field preferred; equivalent combination of relevant experience will be considered in lieu of a degree

What We Offer

• Competitive compensation
• Benefits package that includes health/dental/vision, accrued PTO, and other benefits
• Supportive team environment with growth opportunities
• Stable, mission-driven healthcare organization

E04JI802pvh84099zab