Biller

Accountabilities:

• Resolve disputed medical claims by gathering, verifying, and providing additional information and following up with relevant parties.
• Investigate billing discrepancies by reviewing and evaluating available data and determining appropriate corrective actions.
• Work with medical staff, external agencies, payers, and other stakeholders to identify and resolve claim-related issues.
• Apply established billing, coding, collection, and operational policies and procedures to daily activities.
• Maintain accurate and high-quality billing results by following established standards and identifying potential compliance concerns.
• Report operational or compliance issues through the appropriate channels.
• Apply knowledge of Medicare, Medicaid, third-party payer requirements, reimbursement procedures, and applicable regulations when reviewing claims.
• Maintain current knowledge of medical billing and reimbursement practices through continuing education, professional publications, and industry updates.
• Gather, organize, and report claim information accurately and efficiently.
• Analyze utilization and billing issues and identify practical solutions.
• Maintain professional and courteous communication with internal and external customers.
• Perform additional billing, administrative, or related duties as assigned.
• Manage a high volume of telephone and billing-related activity while maintaining accuracy and service quality.

Requirements:

• High school diploma or equivalent required.
• At least 2 years of experience with medical office billing procedures.
• Billing certification is preferred.
• Working knowledge of clinic policies and procedures and healthcare billing workflows.
• Familiarity with third-party payers, Medicare, Medicaid, billing and collections processes.
• Knowledge of HCPCS, CPT, and ICD coding concepts.
• Understanding of medical terminology and the ability to analyze healthcare-related information.
• Knowledge of collection practices and applicable governmental, legal, and regulatory requirements.
• Comfortable working with computer systems, Windows-based applications, data-entry tools, spreadsheets, and other standard office software.
• Strong ability to gather, analyze, and communicate claim information.
• Demonstrated problem-solving skills, particularly when investigating discrepancies, utilization issues, and disputed claims.
• Strong written and verbal communication skills with a professional customer-service approach.
• Ability to work effectively with medical professionals, external agencies, internal teams, and other stakeholders.
• Strong attention to detail, organization, and accuracy.
• Ability to work independently, follow established procedures, and manage priorities in a busy environment.
• Professional, courteous, and reliable approach when interacting with internal and external customers.

Benefits:

• Fully remote work opportunity.
• Comprehensive health insurance.
• Dental insurance.
• Vision insurance.
• Health Savings Account (HSA) with an employer contribution.
• Life insurance.
• Paid time off (PTO).
• 401(k) retirement plan with employer matching.
• Additional benefits and programs may be available.
• Opportunity to develop and maintain expertise in healthcare billing, claims, reimbursement, and collections.