Medical Biller

Medical Biller Primary Care Practice


Job Title: Medical Biller
Department: Billing/Revenue Cycle
Reports To: Practice Manager or Billing Supervisor
Location: Hagerstown, MD
Employment Type: Full-Time/Part-Time

Job Summary
The Medical Biller is responsible for managing the billing process for a primary care practice, including claim submission, payment posting, insurance follow-up, and patient billing. This role ensures accurate coding and billing, timely reimbursement, and compliance with healthcare regulations.

Key Responsibilities

• Prepare and submit electronic and paper insurance claims for primary care services.
• Verify patient insurance coverage and benefits before claim submission.
• Review patient charts for completeness and billing accuracy.
• Post insurance and patient payments into the practice management system.
• Investigate and resolve claim denials and rejections.
• Follow up with insurance companies regarding unpaid or underpaid claims.
• Generate and send patient statements and manage patient billing inquiries.
• Coordinate with front desk staff and clinical providers to correct billing issues.
• Maintain accurate billing records and documentation.
• Ensure compliance with HIPAA and payer billing guidelines.
• Assist with monthly billing reports and revenue tracking.

Required Qualifications

• High school diploma or equivalent required.
• 13 years of medical billing experience, preferably in a primary care setting.
• Knowledge of CPT, ICD-10, and HCPCS coding systems.
• Experience with electronic health records (EHR) and practice management software.
• Familiarity with Medicare, Medicaid, and commercial insurance billing.
• Strong attention to detail and organizational skills.
• Excellent communication and problem-solving abilities.

Preferred Qualifications

• Certification such as Certified Professional Biller (CPB) or Certified Professional Coder (CPC).
• Experience with primary care billing workflows.
• Knowledge of medical terminology and healthcare reimbursement processes.

Skills

• Insurance claim management
• Denial resolution
• Patient billing and collections
• Data entry and accuracy
• Time management and multitasking
• Customer service and patient communication

Physical Requirements

• Prolonged periods of sitting at a desk and working on a computer.
• Ability to handle standard office equipment.