Key responsibilities

Perform accurate and timely charge entry and billing data entry within 24 hours of receipt
Validate services, charges, modifiers, and payer requirements to ensure billing accuracy
Append appropriate modifiers and re-code denied, rejected, or incorrect claims
Identify missing or incomplete charges and ensure all billable services are entered and reconciled by month-end
Analyze accounts receivable data, identify variances, trends, and discrepancies, and provide supporting documentation
Perform billing and payment reconciliations across Medicare, Medicaid, and private payers
Prepare reports related to billing activity, denials, adjustments, and reconciliations for management review
Communicate with personnel regarding coding, documentation, or billing discrepancies for corrective action and rebilling
Maintain compliance with HIPAA, payer regulations, and federal guidelines
Support special projects and ad hoc analyses as requested

Qualifications

High school diploma required; associate degree preferred
CPC, CCS, or CPB required
Minimum 5 years of experience in medical billing, data entry, and A/R analysis
Proficiency with EHR systems, billing software, SQL, and Microsoft Excel/Outlook
Experience with 835 remittance, 837 claim submittal, and 270/271 eligibility files preferred
Strong attention to detail and ability to manage high-volume, detail-oriented work
Excellent analytical, organizational, and communication skills
Ability to meet deadlines and reconcile complex billing and payment data accurately