Medical Biller

Job Summary

The Medical Biller is responsible for managing the administrative process of submitting insurance claims to payers on behalf of a healthcare provider, including verifying patient insurance coverage, preparing and submitting accurate medical bills, following up on unpaid claims, resolving billing discrepancies and communicating with patients regarding outstanding balances to ensure timely payments for medical services rendered.

Job Responsibilities

• Claim submission: Creating and submitting electronic or paper claims to insurance companies, including accurate coding of diagnoses and procedures based on medical records.
• Patient verification: Checking patient insurance eligibility and benefits, obtaining pre-authorizations for procedures when necessary.
• Billing accuracy: Reviewing medical records for completeness and accuracy to ensure proper billing.
• Claim follow-up: Monitoring claim status, contacting insurance companies to resolve claim denials or billing issues, and initiating appeals when necessary.
• Patient communication: Explaining patient bills, addressing billing inquiries, and setting up payment plans for outstanding balances.
• Data management: Maintaining patient demographic information and billing records within electronic health records (EHR) systems.
• Compliance: Adhering to HIPAA regulations and staying updated on healthcare billing guidelines and coding practices.
• Other responsibilities/duties as assigned.

Job Qualifications

• Proficient in medical billing software and electronic health records (EHR) systems.
• Strong Knowledge of Medical coding and medical collection processes.
• Excellent Attention to Detail with strong organizational skills, patients and insurance representatives.
• Associate degree related field preferred or 5 years of medical billing work experience