Medical Billing Specialist - START IMMEDIATELY

Job Title : Medical Biller

Position Summary

The Medical Biller is responsible for accurately reviewing, preparing, and submitting medical claims to insurance providers, with a strong focus on TRICARE and Medicare billing guidelines. This role ensures timely reimbursement by following up on outstanding claims, resolving denials, and maintaining detailed financial records. Proficiency with Bonafide or Brightree software is required.

Key Responsibilities

Prepare, review, and submit medical claims to TRICARE, Medicare, commercial payers, and secondary insurers.

Verify patient insurance eligibility and benefits prior to claim submission.

Ensure claims comply with payer-specific requirements and current billing regulations.

Monitor claim status, follow up on unpaid or rejected claims, and correct or resubmit as needed.

Review Explanation of Benefits (EOB) and Remittance Advice (RA) for accuracy.

Post payments, adjustments, and denials in the practice management system.

Communicate professionally with insurance representatives, patients, and internal staff to resolve account issues.

Maintain comprehensive billing records while safeguarding PHI in accordance with HIPAA standards.

Generate and review A / R reports to track outstanding balances and prioritize claim follow-up.

Assist with month-end reporting, audits, and compliance activities as required.

Required Qualifications

1-3 years of medical billing experience , preferably in a clinical, home health, or DME environment.

Hands-on experience with TRICARE and Medicare billing , including understanding of coverage rules, modifiers, LCDs, and claim filing timelines.

Proficiency with Bonafide or Brightree software (at least one required).

Strong understanding of CPT, HCPCS, ICD-10 coding basics (certification not required but preferred).

Experience managing claim denials, appeals, and payer follow-up.

Ability to analyze financial data and maintain accurate records.

Strong communication, organization, and problem-solving skills.

Familiarity with HIPAA regulations and medical billing compliance standards.

Preferred Qualifications

Certified Professional Biller (CPB), Certified Medical Reimbursement Specialist (CMRS), or similar credential.

Experience in DME, home health, or specialty practice billing.

Knowledge of additional payer portals and claim management tools.

Work Environment

Full-time or part-time (customize as needed)

Remote, hybrid, or in-office depending on employer

Fast-paced billing environment requiring accuracy and attention to detail

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