Medical Biller

Job Description

Specific Role:

Medical Biller

Reports To:

Revenue Cycle Manager

Department:

Finance

Location:

Main Admin
85048

BLS Occ:

Medical Records Specialist

(SOC 29-2072)

Salary Range:

$22.00-$28.00

Schedule:

FT M-F 8-5

Travel:

None

• Generate andsubmitclean claims (electronic and paper) for all services provided by the practice
• Review documentation, coding, modifiers, and charge capture for accuracy prior to submission
• Ensure compliance with payer-specific guidelines and private practice workflows.

• Monitor insurance and patient A/R aging reports and prioritizetimelyfollow-up.
• Investigate, correct, and resubmit denied or rejected claims
• Comfortable with communicating with insurance companies to resolve claim issues, eligibility concerns, or authorization discrepancies over phone or email.
• Document all actions taken in the practice management system

• Generate patient statements andassistwith questionsregardingbalances, payment plans, or billing inquiries
• Explain EOBs, patient responsibility, and deductible/coinsurance in clear, patient-friendly language
• Support front office and clinical teams in understanding billing-related requirements.
• Answer phone calls and voicemail sin a timely mannertoassistpatients and staff with questions related to patient billing

• Work closelywithcoders to ensure proper CPT, ICD-10, and HCPCS coding
• Identify documentation gaps and request clarifications as needed.
Maintain compliance with federal, state, and payer regulations, including HIPAA, CMS, and Payers

• Partner with administrative staff to ensure efficient flow of informationrequiredto bill correctlyandtimely
• Notifyleadershipoftrends such as recurring denials, payer issues, coding errors, or revenue risks

• Prepare weekly/monthly billing reports as assigned (A/R aging, denial trends, productivity, etc.)
• Provide feedback to the Revenue Cycle Manager on improvement opportunities
• Must be able to sit continuously for 8 hours
• Performs other duties as assigned by supervisor or management to support operational and organizational needs.

• High school diploma or equivalent required
• Associate’s degree beneficial

• 2+ years of medical billing experience in a private practice or multi-provider outpatient setting
• Knowledge of CPT, ICD-10, HCPCS, and insurance billing rules
• Experience with electronic health record (EHR) and practice management systems
• Strong understanding of commercial insurance, Medicare/Medicaid, and specialty payer rules
• Excellent attention to detail, accuracy, and time management

• Experience inspecialtypractice (e.g., neurology, infusion, pain, cardiology)
• CPC, CPB, or related medical billing/coding certification
• Familiarity with multi-location billing workflows
• Athena EHR preferred

• Strong analytical and problem-solving skills.
• Professional communication with patients, staff, and insurance representatives.
• Ability to work independently and manage competing priorities.
• High levelof confidentiality and integrity.