Under the direct supervision of the Director of Business Office, the Medical Biller is responsible for using Athena and NextGen practice management systems to prepare and post fee tickets, post and balance payments, handle billing calls, work aging for various programs and payers, send patient statements, run month-end reports, and submit third-party claims electronically and/or manually.
The role also supports provider and facility insurance paneling, maintains knowledge of CPT, HCPC, and ICD-10 coding practices, and ensures compliance with HIPAA and payer-specific requirements and guidelines.
This position is structured across three levels:
- Medical Biller I: Posts daily fee tickets, reviews coding accuracy, checks for covered services, manages claim worklists, assists patients with billing and insurance questions, applies payments, audits sliding fee payer records, and responds to billing messages.
- Medical Biller II: Performs all Biller I duties and additionally reconciles deposits, processes third-party claims, resolves reimbursement issues, works aging reports for billing and coding errors, and prepares month-end balancing reports.
- Medical Biller III: Performs all Biller I and II duties and additionally updates both practice management systems, processes EDI files for dental services, audits aging and denial reports, assists with coding and claim denials, supports specialty service coding, helps establish training curriculums, and panels providers with insurers using CAQH and Paves.
High school diploma or GED required.
- Medical Biller I: Two years of experience in medical billing and collections; ability to maintain effective working relationships; strong organizational skills; computer literacy.
- Medical Biller II: Same as Biller I, plus experience with inpatient services, procedures, surgeries, billing modifiers, CPT, HCPC coding, and ICD-10 diagnosis coding.
- Medical Biller III: Same as Biller I and II, plus experience generating reports, provider insurance paneling, understanding denial reason codes and aging reports, assisting with staff training setup, maintaining practice management systems, and transmitting dental claims electronically.
Additional requirements include:
- Strong written and verbal communication skills
- Basic math and reasoning ability
- Proficiency with word processing, spreadsheets, email, and keyboarding
- Microsoft Office and Google Suite skills
- Preferred experience with EHR, Athena, and NextGen
- Current, valid, unrestricted California Class C driver’s license
- Ability to pass background check and drug screen
- Compliance with health screening and immunization requirements
- Bilingual English/another language preferred but not required
Location
California, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
1 month ago