Medical Biller - RH Community Builders

Position Summary:

We are seeking a skilled and detail-oriented Medical Biller to join our team. The Medical Biller will be responsible for accurately processing and submitting medical claims, ensuring timely reimbursement from insurance companies, and maintaining compliance with relevant healthcare regulations. The ideal candidate should possess strong organizational and communication skills, alongside a solid understanding of insurance procedures and medical coding practices.

Responsibilities:1. Prepare and submit electronic or paper claims to medical insurance companies, ensuring accurate and timely billing.2. Verify patient insurance coverage and eligibility, including pre-authorizations and referrals, as required.3. Review documentation to accurately code diagnoses and procedures.4. Utilize appropriate coding systems, such as ICD-10 and CPT, to assign accurate medical codes for billing purposes.5. Identify and resolve billing errors, discrepancies, and denials by following up with insurance companies, patients, and healthcare providers.6. Respond to inquiries from insurance companies, patients, and internal staff regarding claims and billing issues in a timely and professional manner.7. Maintain up-to-date knowledge of insurance regulations, policies, and procedures, ensuring compliance in all billing activities.8. Collaborate with other medical billing and coding professionals to ensure accuracy and consistency in coding practices.9. Prepare and analyze reports related to billing and reimbursement metrics, identifying areas for improvement and presenting findings to management.10. Maintain patient confidentiality and adhere to HIPAA guidelines in all aspects of job responsibilities.

Requirements:1. High school diploma or equivalent; certification in medical billing or coding is preferred.2. Proven work experience as a Medical Biller or in a similar role within a healthcare setting.3. Knowledge of medical terminology, coding systems, and insurance procedures (ICD-10, CPT, HCPCS, and CMS 1500).4. Familiarity with electronic medical record (EMR) systems and medical billing software, such as EPIC, eClinicalWorks, or NextGen.5. Proficient in using Microsoft Office Suite (particularly Excel) and other relevant software applications.6. Strong attention to detail and excellent organizational skills to manage multiple tasks and deadlines effectively.7. Excellent interpersonal and communication skills to interact with insurance companies, patients, and healthcare providers in a professional manner.8. Ability to maintain confidentiality of sensitive patient information and observation of HIPAA regulations.9. Strong analytical and problem-solving abilities to identify billing errors, discrepancies, and denials.10. Ability to work independently as well as collaboratively in a team environment.