Medical Biller I

Medical Biller I

Rewarding career. Competitive salary. Outstanding benefits.

Medical Biller I is responsible for supporting the billing and accounts receivable functions within Patient Financial Services. This position assists with basic billing tasks, claim processing, and follow-up activities under the guidance of senior staff. The Medical Biller I works with patients, insurance payers, and internal departments to ensure accurate account handling and a positive patient financial experience. This role is designed to build foundational knowledge of hospital billing processes within a Critical Access Hospital (CAH) environment.

• Promotes a Positive Working Environment
  • Conducts oneself in line with organization's mission, values and standards of behavior.
  • Accepts change and challenges with a positive attitude.
  • Consistently adheres to organizational policy.
• Communicates Effectively
  • Builds relationships and works collaboratively with other staff.
  • Provides timely operational updates to supervisor.
  • Responds to communications in a timely manner.
• Performs Duties Efficiently and Effectively
  • Follows procedures.
  • Acts in compliance with applicable federal, state, and local regulations.
  • Performs other duties as assigned.

Patient Interaction and Customer Service

• Serve as a point of contact for patient billing inquiries, providing courteous and clear communication
• Educate patients on their financial responsibility, insurance coverage, and payment options
• Direct complex patient concerns to appropriate senior staff
• Support patients with payment options and assist them with financial assistance resources as needed
• Direct complex patient concerns to appropriate senior staff with professionalism and empathy

Billing & Claims Submission

• Assist with preparing and submitting claims (UB-04 and/or professional) under supervision
• Review accounts for completeness and accuracy prior to claim submission
• Identify and report claim edits, holds, or errors to senior billers for resolution
• Support timely processing of primary and secondary claims

Accounts Receivable & Payer Follow-Up

• Perform routine follow-up on outstanding claims as assigned
• Review claim status using payer portals or internal systems
• Assist in identifying unpaid or denied claims and perform follow workflows
• Document account activity accurately and consistently
• Contact payers for additional information via phone call or portal communication.
• Research and resolve denials related to coordination of benefits, eligibility, patient questionnaires, and other common denials
• Escalate complex reimbursement issues to Medical Biller Lead or Sr. Manager of Billing and Reimbursement

Denials Management & Revenue Protection

• Research and resolve basic denial categories such as eligibility, authorization, and billing errors
• Identify and Route complex denials to appropriate team members based on issue type
• Research and resolve hospital billing denials using Epic and internal workflows
• Maintain clear and compliant account documentation within Epic.

Epic HB System Responsibilities

• Utilize Epic work queues and tools to complete assigned tasks.
• Maintain accurate account notes, claim statuses, and follow-up actions in Epic.
• Report system issues or workflow concerns to supervisor
• Follow established workflows for account handling

Compliance, Audit & Reimbursement Support

• Follow all applicable billing regulations and payer requirements
• Maintain patient confidentiality in accordance with HIPAA
• Adhere to hospital policies and compliance standards
• Participate in training and skill development activities

Team Support & Cross-Coverage

• Provide support to team members as needed
• Participate in department meetings and training sessions
• Demonstrate a willingness to learn billing processes and systems
• Cross-train in basic functions within Patient Financial Services as assigned

Required

• High school diploma or GED
• Basic computer skills and familiarity with Microsoft Office
• Strong attention to detail and willingness to learn
• Good communication and customer service skills

Preferred

• Prior healthcare or billing experience
• Basic knowledge of medical terminology
• Exposure to…