We are seeking a Certified Medical Biller with specialized experience in wound care, grafting/skin substitute billing, and Ultramist therapy. This role is responsible for accurate coding, claim submission, reimbursement optimization, and compliance with payer guidelines related to advanced wound care services. The ideal candidate is detail-oriented, highly knowledgeable in complex billing scenarios, and experienced in navigating payer-specific requirements.
This role will support our transition from using a third-party billing service to building a strong in-house billing function. This position offers flexibility for part-time or full-time engagement based on candidate availability and organizational needs.
Key Responsibilities:
- Prepare, review, and submit medical claims for wound care services, including: Debridement procedures, Skin substitutes / graft applications, Ultramist (non-contact low-frequency ultrasound) therapy
- Ensure accurate CPT, HCPCS, and ICD-10 coding specific to wound care and advanced treatments
- Verify documentation supports billed services and meets payer requirements
- Manage claim follow-up, denials, and appeals to ensure timely reimbursement
- Track and resolve billing discrepancies and underpayments
- Collaborate with clinical teams to ensure proper documentation for wound measurements, staging, progression, and medical necessity for grafts and advanced therapies
- Stay current on Medicare, Medicaid, and commercial payer policies related to wound care billing
- Maintain compliance with all regulatory and payer guidelines
- Generate billing, aging, and reimbursement reports as needed
Qualifications:
- Active certification required (e.g., Certified Professional Biller (CPB), Certified Professional Coder (CPC), or equivalent)
- Minimum 1–2 years of medical billing experience, preferably in wound care or related specialty
- Strong knowledge of wound care billing and coding, skin substitutes/graft billing (Q-codes, modifiers, units), and Ultramist therapy billing
- Familiarity with Medicare guidelines, LCDs, and documentation requirements for wound care
- Experience with EHR/EMR systems and billing software
- Ability to interpret clinical documentation and translate into billable services
- Strong attention to detail, organization, problem-solving skills
- Excellent communication skills for working with providers and payers
Preferred:
- Experience with denial management and appeals specific to wound care claims
- Knowledge of revenue cycle management and payer audit processes
Work Location: Remote
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Vision insurance
Active certification such as CPB or CPC required 1–2 years billing experience in wound care preferred Knowledge of wound care, skin substitutes/grafts, Ultramist therapy billing Familiarity with Medicare/Medicaid payer policies Experience with EHR/EMR and billing software Strong communication and problem-solving skills
401(k) Dental insurance Health insurance Vision insurance
Location
N/A
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
Yes
Posted
3 weeks ago