Medical Claims Biller

Schedule: Monday–Friday, 8:00 AM–5:00 PM

Employment Type: Temp-to-Perm

Start Date: ASAP

Experience

Required:

3–5+ years of relevant experience

The Medical Claims Biller is responsible for managing and monitoring medical claims for one or more doctor practices. This role will utilize electronic health record (EHR) systems and clearinghouse platforms to submit claims, monitor adjudication, research unpaid or denied claims, post insurance payments, and resolve billing issues. The ideal candidate will have strong medical billing and coding experience, excellent attention to detail, and the ability to research claim issues and take appropriate corrective action.

• Review medical claims and transmit claims to insurance carriers using practice EHR systems and clearinghouse platforms.
• Monitor rejected claim reports, identify errors, make necessary corrections, and resubmit claims.
• Download and review insurance Explanation of Payments (EOPs) and accurately post payments and denials in the EHR system.
• Research denied claims and determine whether claims can be corrected and resubmitted.
• Review aging reports to identify outstanding balances and take appropriate action within insurance filing deadlines.
• Research unpaid claims using insurance carrier websites and other available resources.
• Contact insurance carriers as needed to investigate claim status, denials, payment issues, and outstanding balances.
• Perform cash application activities, including accurately posting insurance and patient payments.
• Research unpaid claims to determine why payment was not received and take corrective action to resolve the issue.
• Partner with the clearinghouse to distribute patient billing statements and monitor the patient portal for payments.
• Process patient and insurance over payment refunds and repayments when required.

• High school diploma or equivalent.
• 3+ years of relevant medical billing or claims processing experience; 5 years preferred.
• Hands-on experience with medical billing and coding.
• Experience with insurance claims submission, adjudication, denials, payment posting, and follow-up.
• Experience with cash application and collections-related activities.
• Strong ability to research unpaid claims and identify the underlying reason for non-payment.
• Ability to prioritize multiple tasks and manage work within established deadlines.
• Strong organizational skills and attention to detail.
• Excellent verbal, written, and listening communication skills.
• Ability to work independently as well as collaboratively with practice and corporate teams.

• Experience supporting multiple doctor practices.
• Experience working with multiple medical insurance carriers and understanding payer-specific claim requirements.
• Experience with EHR systems and medical billing clearinghouses.
• Demonstrated ability to identify billing issues, troubleshoot claim problems, and implement effective solutions.
• Experience working with aging reports and insurance filing limits.
• Strong problem-solving and analytical skills.