Medical Biller

Job Description

Job Description

Benefits :

401(k)

401(k) matching

Dental insurance

Health insurance

Vision insurance

Benefits / Perks

• Competitive Compensation
• Health, Vision, and Dental Insurance
• 401K match
• Great Work Environment
• Career Advancement Opportunities

Job Summary

We are seeking a Medical Biller to join our team! In this role, you will oversee the billing process for healthcare services, ensuring accurate claim submissions and full payment collection. Your responsibilities will include reviewing rejected claims, making justified adjustments, handling appeals for denied or underpaid claims, creating monthly Accounts Receivable reports, and resolving issues with provider representatives.

Responsibilities

• Analyze claim denials and take corrective action, including corrected claims, reconsiderations, and appeals.
• Apply accurate adjustments in accordance with insurance guidelines and contracts.
• Manage secondary insurance and patient responsibility.
• Work closely with the team to resolve outstanding insurance payments. This includes pulling insurance policies and setting up system edits and scrubs to prevent future denials.
• Correspond with Insurance Verification and Front Desk to input missing data and correct registration errors.
• Communicate effectively with patients and the front desk regarding balances and collect payments.
• Claims Management : Analyze and resolve rejected claims, ensuring accurate coding and modifiers per payer policies.
• Appeals Process : Research, prepare, and submit appeals for denied or underpaid claims. Draft detailed justification letters supported by documentation and payer policies.
• Collaboration : Coordinate with charge entry personnel and revenue cycle specialists to ensure accurate claim processing and resubmission. Work with providers to optimize appeals and validate adjustments.

Qualifications

• Strong customer service skills
• Previous experience in Allergy, Asthma & Immunology with medical coding or billing is a plus.
• Strong organization skills
• Excellent attention to detail