Medical Biller

Key Responsibilities

• Monitor and manage accounts receivable (A/R) to ensure claims are received, processed, and paid in a timely manner
• Follow up on outstanding, unpaid, rejected, and denied claims with insurance companies
• Research claim status through insurance portals, payer websites, phone calls, and other resources
• Identify and resolve claim issues, including missing information, eligibility issues, incorrect billing, coding concerns, and payer processing errors
• Correct and rebill claims when appropriate
• Document all claim follow-up, correspondence, and actions taken in the practice management system and A/R tracking tools
• Track aging A/R and prioritize follow-up based on payer, claim age, and outstanding balance
• Communicate with insurance companies, attorneys, lien companies, patients, and internal staff regarding billing and claim issues
• Work with providers and clinical staff to obtain clarification or documentation needed to resolve billing issues
• Assist with accurate and timely claim submission and resubmission
• Assist with payment posting and reconciliation as needed
• Identify recurring billing or insurance issues and communicate trends to management
• Maintain patient confidentiality and follow HIPAA and other applicable healthcare regulations

Qualifications

• Previous medical billing experience preferred
• Experience with medical insurance claims, A/R follow-up, denials, and insurance collections
• Familiarity with EMR/EHR and practice management systems
• Knowledge of CPT, ICD-10, and general medical billing practices
• Understanding of EOBs, ERAs, claim denials, appeals, and insurance payment processes
• Strong attention to detail and ability to identify discrepancies
• Excellent organizational and time-management skills
• Strong communication skills and confidence communicating with insurance representatives
• Ability to research problems and follow an issue through to resolution
• Ability to work independently while collaborating effectively with a multidisciplinary team
• Ability to manage multiple priorities in a fast-paced medical office environment

Preferred Qualifications

• Experience with AdvancedMD or similar practice management/billing software
• Experience working with multiple insurance carriers and payer portals
• Experience with physical therapy, speech therapy, behavioral health, or optometry
• Experience handling denied claims, appeals, and complex A/R
• Experience with personal injury, MedPay, workers' compensation, or lien-based accounts is a plus

Benefits

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Paid time off