Medical Office Biller

Job Description

Job Description

Responsible for managing the full cycle of the billing process, which includes preparing, submitting, and following up on claims with insurance companies and patients to ensure timely and accurate payment for healthcare services rendered.

Core Responsibilities

Key duties vary slightly by employer but generally focus on the financial health of the medical practice and patient account management:

• Claim Management: Prepare, review, and submit electronic and paper claims to various insurance payers (e.g., Medicare, Medicaid, private insurers) using standardized coding systems CPT and ICD-10.
• Accounts Receivable (AR) Follow-up: Monitor the status of submitted claims, investigate and appeal denied or unpaid claims, and resolve billing discrepancies with insurance companies.
• Patient Billing & Communication: Generate patient statements, answer patient inquiries regarding bills and insurance coverage, and establish payment plans for outstanding balances.
• Data & Payment Processing: Verify patient insurance eligibility and benefits, accurately post payments and adjustments to patient accounts in billing software, and maintain detailed billing records in compliance with HIPAA regulations.
• Coordination: Collaborate closely with medical coders and healthcare providers to ensure documentation is complete and accurate for billing purposes.

Required Skills & Qualifications

• Education: A high school diploma or equivalent is required; degree or certification in medical billing and coding.
• Experience: Previous experience in a medical office or healthcare administrative role, two or more years of relevant experience.
• Technical Skills: Proficiency in medical billing and electronic health record (EHR) software is essential. Knowledge of medical terminology and coding systems.
• Soft Skills: Strong attention to detail, problem-solving, organizational, and communication skills..
• Compliance: A thorough understanding of healthcare regulations, including the Health Insurance Portability and Accountability Act (HIPAA), is mandatory.