Medical Biller

Job Summary:

The Medical Biller will be responsible for accurately processing billing data, submitting claims to insurance providers, and ensuring maximum reimbursement for services provided. This role involves reviewing and correcting billing errors, resolving denial instances, and maintaining communication/visibility with insurance providers to facilitate smooth billing operations. 

The Medical Biller will also conduct audits and reviews for Medicare and alternative applicable insurance programs, ensuring compliance with relevant regulations. This position requires excellent attention to detail, knowledge of billing processes, and the ability to work in a fast-paced environment to meet deadlines.

Key Responsibilities and Duties:

• Perform posting of charges and completion of claims for submission to various payers.
• Submit billing data to the appropriate insurance providers, ensuring accuracy and timeliness.
• Process and follow up on claims to ensure full reimbursement for services rendered.
• Resolve denial instances and resubmit corrected claims as necessary.
• Work with insurance providers to identify and address any billing discrepancies.
• Conduct audits of billing and claims data to ensure accuracy and compliance.
• Perform Medicare and alternative applicable insurance program reviews to ensure adherence to program requirements.
• Deploy and maintain various billing programs, providing regular reports on billing activities and reimbursement outcomes.
• Ensure all billing activities comply with federal and state regulations.
• Conduct duties in a professional and timely manner, maintaining communication with internal and external stakeholders.

Required Qualifications and Experience:

• Prior experience in medical billing or a similar role, particularly in a medical device or healthcare setting.
• Strong understanding of Medicare and private insurance billing procedures.

Technical Proficiency:

• Familiarity with billing software and electronic medical records (EMR) systems.
• Proficient in Microsoft Office Suite (Word, Excel, etc.).
• Required Communication and Competency Skills:
• Strong verbal and written communication skills to interact effectively with insurance companies and internal teams.
• High level of accuracy in reviewing and processing claims and maintaining billing records.
• Ability to prioritize and manage multiple tasks in a time-sensitive environment.
• Ability to troubleshoot billing issues and resolve them efficiently, ensuring maximum reimbursement