Job Description

Job Title: Medical Biller**

**Department:** Billing Department
**Reports To:** Billing Manager
**Location:** on site ****ONLY ****
**Job Type:** Full-Time

**Job Summary:**
We are seeking a detail-oriented and organized Medical Biller to join our healthcare team. The ideal candidate will be responsible for preparing, submitting, and managing claims to insurance companies for payment of services rendered by healthcare providers. The Medical Biller will ensure that claims are processed efficiently and accurately while maintaining compliance with regulations and standards.

**Key Responsibilities:**

- **Claims Processing:** Prepare and submit accurate claims to insurance companies and government payers (e.g., Medicare, Medicaid) using appropriate coding and billing software.
- **Data Management:** Verify patient information and insurance coverage, ensuring all demographic and billing data is accurate and up to date.
- **Coding Compliance:** Assign appropriate medical codes (ICD, CPT, HCPCS) for diagnoses and procedures based on documentation provided by healthcare providers.
- **Follow-Up:** Track and follow up on unpaid or rejected claims, resolving any discrepancies with payers promptly and effectively.
- **Patient Billing:** Generate patient statements, respond to billing inquiries, and assist patients with insurance-related questions, payment options, and account balances.
- **Accounts Receivable:** Maintain the accounts receivable (AR) aging report, analyzing accounts and making recommendations for collections.
- **Documentation:** Maintain accurate records of billing procedures, claims, payments, adjustments, and denials in compliance with regulations and company policies.
- **Collaboration:** Work collaboratively with healthcare providers, administrative staff, and insurance representatives to ensure smooth billing processes and resolve any issues that arise.
- **Reporting:** Prepare regular reports on billing activities, outstanding claims, and revenue cycle metrics for management review.

**Qualifications:**

- High school diploma or equivalent required
- Certified Professional Biller (CPB) or equivalent certification is a plus.
- Previous experience in medical billing, coding, or healthcare administration is preferred.
- Strong knowledge of medical terminology, billing processes, and insurance guidelines.
- Proficiency with electronic health record (EHR) systems and billing software.
- Excellent attention to detail and organizational skills.
- Strong communication and interpersonal skills, with the ability to work effectively with patients and healthcare professionals.
- Proficient in Microsoft Office Suite, particularly Excel and Word.

**Working Conditions:**
- Primarily office-based work with some remote work opportunities available.
- May require sitting for extended periods and using a computer.

**Benefits:**
- Competitive salary based on experience
- Health, dental, and vision insurance
- Paid time off (PTO) and holidays
- Retirement plan options
- Opportunities for professional development and continuing education

Raincross Medical Group Inc is an equal opportunity employer and values diversity in its workforce. We encourage all qualified applicants to apply.

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