Medical Biller (English)

View full description

Requirements:

• Proven experience as a Medical Biller or Medical Administrative Assistant, ideally in a medical massage clinic.
• Proficiency in medical billing and coding, particularly for CPT and ICD-10 codes.
• Experience with credentialing for in-network and out-of-network providers.
• Skilled in electronic billing systems for managing claims, payments, and account reconciliations.
• Expertise in verifying insurance coverage and eligibility for medical massage services.
• Effective communication skills for handling pre-authorizations, coverage verifications, and patient billing inquiries.
• Experience with EMR systems for managing patient data and documentation.
• Strong organizational skills and attention to detail.
• Knowledge of HIPAA regulations and commitment to maintaining patient privacy.
• Willingness to pursue ongoing training and certification.
• Availability to work Pacific Time (PST) schedule (8:00 AM - 4:00 PM PST).

Responsibilities:

• Utilize CPT & ICD-10 coding expertise to accurately prepare and submit medical insurance claims.
• Ensure timely reimbursement through a deep understanding of insurance claim submissions and reimbursement practices.
• Verify and review claim details for accuracy and compliance with billing regulations.
• Record and reconcile payments received from insurance companies and patients.
• Ensure accurate posting of payments and adjustments in the billing system.
• Collaborate with teams to resolve billing discrepancies and issues.
• Manage patient Account Receivables (A/R), address insurance denials, reprocess claims, and submit corrections or appeals.
• Handle credentialing for major insurance companies, ensuring in-network and out-of-network providers are covered under the client’s NPI.
• Negotiate insurance contracts and ensure hospital and payor credentialing is in place.