Job Description

? Medical Billing & Claims Processing

• Prepare and submit insurance claims to payers, including Medicare, Medicaid, and private insurers.
• Review and verify accuracy of patient billing information before submission.
• Apply appropriate billing codes (ICD-10, CPT, HCPCS) for procedures and diagnoses.
• Resolve denied or rejected claims and resubmit corrected claims when necessary.
• Monitor claim status and follow up with insurance companies to ensure timely payments.

? Insurance Verification & Pre-Authorization

• Verify patient insurance coverage and obtain pre-authorizations as required.
• Communicate with insurance companies to confirm eligibility, benefits, and coverage limits.
• Update patient records with verified insurance details and billing information.

? Payment Posting & Reconciliation

• Post payments from insurance companies, patients, and third parties accurately.
• Reconcile payments, identify discrepancies, and address payment inconsistencies.
• Process refunds, adjustments, and patient credits as needed.

? Patient Billing & Communication

• Generate and send patient statements with clear breakdowns of charges.
• Communicate with patients regarding their billing inquiries and provide payment options.
• Set up and manage payment plans, ensuring timely collections.

? Compliance & Documentation

• Ensure compliance with HIPAA and other healthcare regulations.
• Maintain accurate records of billing activities and follow established protocols.
• Stay updated with changes in billing regulations and payer requirements.

• Bachelor’s degree in healthcare administration or a related field preferred.
• 1-2 years of experience as a medical biller or in a related role.
• Proficiency in medical billing software (e.g., Kareo, AdvancedMD, or Medisoft).
• Strong understanding of medical terminology, coding systems (ICD-10, CPT, HCPCS), and insurance processes.
• Excellent attention to detail and accuracy in data entry and billing.
• Strong organizational and time management skills.

Please refer to job description.