Job Description
Job Description
Position Summary:
The Medical Biller and Collector will be responsible for the full billing cycle, including charge entry, claim submission, payment posting, denial management, patient collections, and AR follow-up. The ideal candidate is organized, knowledgeable in medical billing procedures and payer guidelines, and proactive in resolving billing issues.
Key Responsibilities:
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Accurately enter and submit medical claims (electronic and paper) to insurance carriers and third-party payers.
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Monitor and follow up on unpaid claims within timely filing limits.
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Review EOBs and ERAs to post payments and identify underpayments or denials.
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Conduct thorough denial management, including appeals and resubmissions.
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Proactively contact insurance companies for claim status and clarification.
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Manage patient balances, send statements, and follow up via phone or written communication.
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Maintain detailed documentation of billing activities and patient interactions.
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Ensure compliance with HIPAA, payer regulations, and industry standards.
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Collaborate with front office, clinical staff, and management to ensure accurate coding, documentation, and communication.
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Prepare and present monthly AR aging and collection reports.
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Credentialing or payer enrollment tasks.
Qualifications:
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High school diploma or equivalent required; associate’s degree or certification in medical billing preferred.
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Minimum 2–3 years of experience in medical billing and collections, preferably in a specialty practice.
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Strong knowledge of CPT, ICD-10, HCPCS codes, modifiers, and payer-specific guidelines.
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Experience with electronic health records (EHR) and billing software.
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Familiarity with Medicare, Medicaid, commercial insurance, and workers’ compensation.
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Excellent verbal and written communication skills.
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High level of accuracy, problem-solving, and follow-through.
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Able to work independently and as part of a team in a fast-paced environment.
Preferred Skills:
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Certification from AAPC (e.g., CPC, CPB) or AHIMA is a plus.
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Experience with prior authorizations and insurance verification.
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Bilingual (English/Spanish) a plus but not required.