Medical Biller - Remote | WFH

Summary

As a valued member of our team, the Medical Biller plays a crucial role in ensuring accurate billing processes, timely reimbursement, and efficient documentation management. Under the guidance of the lead medical biller and departmental leaders, you will be responsible for collaborating with various departments and third-party payers to ensure seamless follow-up, denials management, and appeals processing.

Key Responsibilities

Process electronic billing files and submit insurance claims to third-party payers on a daily basis.

Review, evaluate, and forward manual patient account statements to payers that require special handling.

Assist in managing correspondence related to Explanation of Benefits (EOBs), payer notices, and payer audits/record reviews.

Monitor bill holds, payer rejections, and electronic payers' error reports, coordinating with other departments to resolve issues and ensure timely claim submission.

Collaborate with other departments to clarify medical codes, modifiers, and other claim-related elements.

Follow up on aged claims, documenting all reimbursement delays and actions taken within the patient accounting system.

Evaluate claim denials and initiate the appeals process when necessary, noting trends and informing supervisors to prevent future rejections.

Maintain a general understanding of billing regulations and ensure compliance within the department.

Review, investigate, and resolve credit balances.

Perform additional duties as assigned by departmental leaders.

Qualifications

High School Diploma required; Associate's Degree preferred.

Minimum of 2 years of customer service and/or business office experience, preferably in a medical setting.

We look forward to welcoming a dedicated and detail-oriented individual to our team who shares our commitment to excellence in healthcare billing practices.

Employment Type: Full-Time