Business Office Biller

Position Summary The Hospital Biller is responsible for accurate and timely billing of inpatient, outpatient, clinic, and ancillary services in accordance with Medicare, Medicaid, and commercial payer requirements. This role is critical in supporting the financial health of the Critical Access Hospital while ensuring compliance with federal and state regulations.

Essential Duties and Responsibilities Prepare, review, and submit claims for inpatient, outpatient, clinic, emergency, and ancillary services

Ensure compliance with CAH billing regulations, including cost-based reimbursement guidelines

Verify patient insurance coverage and benefits prior to billing

Correct billing errors, edit claims, and resolve rejections or denials

Post payments, adjustments, and contractual allowances accurately

Follow up on unpaid claims and communicate with payers as needed

Maintain accurate billing records and documentation for audits and surveys

Collaborate with coding, registration, and clinical departments to resolve discrepancies

Respond to patient billing inquiries professionally and confidentially

Assist with month-end close, reports, and reimbursement tracking

Support internal and external audits, including Medicare and Medicaid reviews

Knowledge, Skills, and Abilities Knowledge of hospital billing processes, including Medicare, Medicaid, and commercial payers

Familiarity with CAH-specific billing and reimbursement rules

Strong attention to detail and accuracy

Ability to manage multiple priorities in a fast-paced environment

Effective communication and customer service skills

Proficiency with hospital billing systems and electronic health records

Education and Experience High school diploma or equivalent required

Associate degree in healthcare administration, business, or related field preferred

Minimum of 1–3 years of hospital billing experience, preferably in a CAH setting

Experience with Medicare cost-based billing strongly preferred

Certifications (Preferred)
Certified Professional Biller (CPB) or equivalent

Experience with Medicare Rural Hospital or CAH billing regulations

Physical and Work Requirements Ability to sit for extended periods

Frequent use of computer and office equipment

Occasional lifting of office materials up to 25 pounds

Compliance Statement All employees are expected to adhere to hospital policies, HIPAA regulations, and federal and state compliance standards.
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