Medical Biller/Collections

Job Title: Medical Biller - Hybrid

Summary: The Medical Biller is responsible for accurately and efficiently billing healthcare services and processing insurance claims. They ensure proper coding, documentation, and adherence to billing regulations, optimizing revenue collection for medical facilities while maintaining patient confidentiality.

Key Responsibilities:

1. Billing and Coding:

   • Utilize medical coding systems (such as ICD-10, CPT, and HCPCS) to accurately code diagnoses, procedures, and services.
   • Review and verify completeness and accuracy of patient information, procedures, and diagnoses for billing purposes.

2. Claims Processing:

   • Prepare and submit insurance claims electronically or by paper to insurance companies.
   • Follow up on unpaid or rejected claims, resolving any issues or discrepancies to ensure timely reimbursement.

3. Patient Billing:

   • Generate patient statements and bills for services rendered.
   • Communicate with patients regarding billing inquiries, explaining charges, and assisting with payment plans or financial assistance programs.

4. Compliance and Documentation:

   • Stay updated on healthcare billing regulations and compliance standards.
   • Maintain detailed and accurate records of billing activities, ensuring proper documentation for audits and reviews.

5. Collaboration:

   • Coordinate with healthcare providers, administrative staff, and insurance companies to resolve billing issues and ensure accurate billing practices.

Requirements:

• Proven experience as a Medical Biller or in a similar role within healthcare administration.
• Proficiency in medical billing software and coding systems (ICD-10, CPT, HCPCS).
• Strong knowledge of insurance guidelines, policies, and procedures.
• Excellent attention to detail, organizational skills, and ability to work in a fast-paced environment.
• Effective communication and interpersonal skills for interactions with patients, colleagues, and insurance companies.
• Understanding of medical terminology and procedures.

Education and Certification:

• High school diploma or equivalent; additional certification in Medical Billing and Coding is preferred.
• Certification such as Certified Professional Biller (CPB) or Certified Professional Coder (CPC) is a plus.

Training and Work Environment:

• The position includes a 90-day onsite training period to familiarize with systems and procedures.
• Offers flexible start times within a Monday through Friday work schedule, accommodating various work-life balances.
• The role primarily operates remotely, with one day per month required onsite for meetings, reviews, or as necessary for operational purposes.

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