Medical Biller

Responsibilities

• Submit accurate and timely medical claims to commercial insurance, Medicare, Medicaid, and other payers.
• Review claims for accuracy, including CPT, HCPCS, ICD-10, modifiers, and insurance information.
• Monitor claim status and follow up on unpaid, rejected, and denied claims.
• Research and resolve claim denials, payment discrepancies, and billing issues.
• Post insurance and patient payments accurately to patient accounts.
• Process insurance EOBs and ERAs and reconcile payments.
• Work accounts receivable and follow up on outstanding balances.
• Submit corrected claims, appeals, and reconsiderations as needed.
• Verify insurance benefits and assist with resolving coverage and authorization issues.
• Communicate with insurance companies regarding claims, eligibility, benefits, and payment issues.
• Maintain accurate billing documentation and patient account records.
• Follow HIPAA, payer requirements, and practice billing policies.
• Work closely with the front office, clinical staff, and providers to resolve billing issues.

Qualifications

• 2+ years of medical billing experience preferred.
• Knowledge of Medicare, Medicaid, and commercial insurance billing.
• Understanding of CPT, HCPCS, ICD-10, and medical billing terminology.
• Experience with electronic claims submission and clearinghouse processes.
• Strong knowledge of insurance denials, appeals, and accounts receivable.
• Strong attention to detail and accuracy.
• Excellent organizational and follow-up skills.
• Ability to work independently and meet deadlines.
• Strong communication and problem-solving skills.
• Rheumatology, specialty practice, or infusion billing experience preferred.
• Experience with CareCloud or similar electronic medical record/billing systems preferred.