Medical Biller

Integrated ENT Allergy & Immunology is seeking an experienced and detail-oriented Medical Biller to join our growing Revenue Cycle team. The Medical Biller is responsible for accurately preparing, submitting, and following up on medical claims to ensure timely reimbursement while maintaining compliance with payer guidelines and healthcare regulations. The ideal candidate possesses strong analytical skills, a thorough understanding of medical billing processes, and the ability to effectively communicate with insurance carriers, patients, and internal staff.

·         Review patient accounts for billing accuracy, completeness, and required documentation prior to claim submission.

·         Prepare, review, and submit electronic and paper insurance claims in a timely manner.

·         Verify insurance eligibility and benefits when necessary.

·         Monitor claims throughout the revenue cycle and follow up on unpaid, delayed, or rejected claims.

·         Review insurance payments to ensure reimbursement complies with contracted payer agreements.

·         Investigate payment discrepancies and communicate with insurance carriers to resolve claim issues.

·         Identify, submit, and bill for secondary and tertiary insurance claims as appropriate.

·         Research, prepare, and submit appeals for denied or underpaid claims.

·         Review patient accounts for outstanding balances and coordinate appropriate follow-up.

·         Respond professionally to patient and insurance inquiries regarding billing, claims, and account balances.

·         Establish payment arrangements with patients when appropriate.

·         Maintain accurate documentation of all billing activities within the practice management system.

·         Update billing software, fee schedules, and payer information as directed.

·         Prepare collection reports and reconcile payment information.

·         Collaborate with providers, clinical staff, and the Revenue Cycle team to resolve billing issues efficiently.

·         Ensure compliance with HIPAA, Medicare, Medicaid, commercial payer regulations, and company policies.

·         Maintain confidentiality of all patient and financial information.

·         Perform additional revenue cycle duties as assigned.

·         Certification in Medical Billing, Medical Administration, or related healthcare field preferred.

·         Associate degree in Business Administration, Accounting, Healthcare Administration, or related field preferred.

·         Minimum of one (1) to three (3) years of medical billing experience in a physician practice or healthcare setting.

·         Working knowledge of medical billing procedures, insurance claim processing, and accounts for receivable management.

·         Proficiency with electronic medical record (EMR) systems and medical billing software.

·         Strong computer skills, including Microsoft Office applications.

·         Knowledge of CPT, ICD-10-CM, and HCPCS coding principles.

·         Familiarity with Medicare, Medicaid, HMO, PPO, and commercial insurance guidelines.

·         Strong analytical and problem-solving abilities.

·         Excellent attention to detail and organizational skills.

·         Ability to manage multiple priorities while meeting deadlines.

·         Strong written and verbal communication skills.

·         Excellent customer service skills when interacting with patients and insurance representatives.

·         Ability to research and resolve claim denials, payment discrepancies, and reimbursement issues.

·         Knowledge of accounting and bookkeeping principles related to healthcare revenue cycle operations.

·         Ability to work independently and collaboratively within a team environment.

·         Commitment to maintaining patient confidentiality and HIPAA compliance.

·         Ability to exercise sound judgment and professionalism in all interactions.