Medical Biller

Summary

The Medical Biller is responsible for ensuring all providers’ encounters are coded, billed and submitted in a timely manner to insurance companies, while also monitoring and resolving any rejections or denials through company billing portals. This position is essential to ensuring clean claim submission, reducing delays in reimbursement, and supporting compliance with payer and CMS guidelines.

Essential Duties and Responsibilities

• Review, verify and submit provider encounters for accuracy in coding and documentation.
• Ensure timely and clean claim submission through appropriated billing software.
• Correct and resubmit rejected claims with proper supporting documentation or edits.
• Communicate with providers and clinical teams as needed to clarify documentation or encounter issues.
• Work closely with internal MRA coders to resolve discrepancies in diagnosis or procedures codes.
• Maintain billing logs and status update to ensure all encounters are accounted for and processed.
• Identify trends in denials or rejections and escalate to leadership as needed.
• Road travel required – up to 25% (Miami-Dade, Broward, and Palm Beach counties)
• Perform any other duties as assigned.

Knowledge, Skills and Abilities

• Strong understanding of CPT, ICD-10, HCPCS coding and billing regulations.
• Proficiency in medical billing systems and clearing house platforms.
• Familiarity with EMRs (e.g., eClinicalWorks, Practice Fusion, Athena).
• Ability to analyze and resolve claim denials and rejections effectively.
• Proficiency in Microsoft Office tools, especially Excel, Outlook, and Teams
• Strong organizational and time-management skills with attention to detail.
• Effective written and verbal communication skills.
• Ability to collaborate across multiple departments and providers.
• Knowledge of MSO/ACO environments and value-based care billing models is a plus.

Minimum Education and Experience

• High school diploma or equivalent required.
• Certified Professional Biller (CPB) or Certified Professional Coder (CPC) credential required.
• Minimum of 1 year of experience in medical billing and coding.
• Experience working with multi-provider practices preferred.
• Bilingual (English/Spanish) required.

Note: Nothing in this job specification restricts management’s right to assign or reassign duties and responsibilities to this job at any time. Critical features of this job are described under various headings above. They may be subject to change at any time due to reasonable accommodation or other reasons. The above statements are strictly intended to describe the general nature and level of the work being performed. They are not intended to be construed as a complete list of all responsibilities, duties, and skills required of employees in this position.