We are seeking a detail-oriented and experienced Medical Biller to join our healthcare billing team. The ideal candidate will have a strong understanding of medical billing procedures, insurance processes, and denial resolution, with hands-on experience in working with both public and private payers.

Key Responsibilities:

• Submit accurate claims to private insurance companies, Medicaid, and Medicare
• Perform insurance verification, pre-authorization, and eligibility checks
• Review and analyze explanation of benefits (EOBs) and resolve claim denials effectively
• Draft and submit timely appeals with proper documentation
• Handle Coordination of Benefits (COB) and manage out-of-network denial cases
• Use knowledge of CPT/HCPCS and ICD codes to ensure correct claim submission
• Identify and address common denial reasons (e.g., no prior authorization, non-covered services, coding errors)
• Maintain up-to-date records and billing documentation in compliance with industry standards
• Collaborate with providers, patients, and payers to ensure prompt claim resolution

Requirements:

• Proven experience in medical billing and claims management
• Proficiency in working with Medicare, Medicaid, and private insurance plans
• Strong knowledge of CPT/HCPCS coding systems and billing regulations
• Experience in denial analysis, appeals, and insurance correspondence
• Familiarity with COB processes and payer-specific requirements
• Attention to detail, problem-solving mindset, and the ability to work independently
• Excellent communication and documentation skills
• Proficiency in medical billing software and Microsoft Office tools

Preferred Qualifications:

• Certification in Medical Billing or Coding (e.g., CPC, CMRS, CBCS)
• Experience in a multi-specialty billing environment
• Prior work with EMR/EHR systems

Job Type: Full-time

Work Location: In person