Biller Medical

Job Description

Job Description

Description:

This position is: Full-Time Monday-Friday 8am-5pm In-Office

Wage is dependent upon years of experience, education and certifications.

The Medical Biller is responsible for ensuring accurate, timely, and compliant billing for all patient encounters within a private medical practice. This role supports the revenue cycle by preparing claims, reviewing coding accuracy, resolving denials, and working closely with insurance, clinical staff, patients, and payers. The Medical Biller plays a critical role in maximizing reimbursement, reducing errors, and supporting financial stability for the practice.

Key Responsibilities:

Claim Preparation & Submission

• Generate and submit clean claims (electronic and paper) for all services provided by the practice
• Review documentation, coding, modifiers, and charge capture for accuracy prior to submission
• Ensure compliance with payer-specific guidelines and private practice workflows.

Accounts Receivable (A/R) & Denial Management

• Monitor insurance and patient A/R aging reports and prioritize timely follow-up.
• Investigate, correct, and resubmit denied or rejected claims
• Comfortable with communicating with insurance companies to resolve claim issues, eligibility concerns, or authorization discrepancies over phone or email.
• Document all actions taken in the practice management system

Patient Billing & Collection Support

• Generate patient statements and assist with questions regarding balances, payment plans, or billing inquiries
• Explain EOBs, patient responsibility, and deductible/coinsurance in clear, patient-friendly language
• Support front office and clinical teams in understanding billing-related requirements.
• Answer phone calls and voicemails in a timely manner to assist patients and staff with questions related to patient billing

Coding Accuracy & Compliance

• Work closely with coders to ensure proper CPT, ICD-10, and HCPCS coding
• Identify documentation gaps and request clarifications as needed.
• Maintain compliance with federal, state, and payer regulations, including HIPAA, CMS, and Payers

Internal Communication & Collaboration

• Partner with administrative staff to ensure efficient flow of information required to bill correctly and timely
• Notify leadership of trends such as recurring denials, payer issues, coding errors, or revenue risks

Reporting

• Prepare weekly/monthly billing reports as assigned (A/R aging, denial trends, productivity, etc.)
• Provide feedback to the Revenue Cycle Manager on improvement opportunities

Education:

• High school diploma or equivalent required
• Associate’s degree beneficial

Experience:

• 2+ years of medical billing experience in a private practice or multi-provider outpatient setting
• Knowledge of CPT, ICD-10, HCPCS, and insurance billing rules
• Experience with electronic health record (EHR) and practice management systems
• Strong understanding of commercial insurance, Medicare/Medicaid, and specialty payer rules
• Excellent attention to detail, accuracy, and time management

Preferred

• Experience in specialty practice (e.g., neurology, infusion, pain, cardiology)
• CPC, CPB, or related medical billing/coding certification
• Familiarity with multi-location billing workflows
• Athena EHR preferred

Qualifications/Skills:

• Strong analytical and problem-solving skills.
• Professional communication with patients, staff, and insurance representatives.
• Ability to work independently and manage competing priorities.
• High level of confidentiality and integrity.
• Strong computer proficiency including EHR systems, billing platforms, and Excel.
• Ability to sit for extended periods.
• Occasional interaction with patients at the front desk or over the phone.
• Ability to work in a cubicle setting with a large group of people
• Positive attitude and a collaborative demeanor