Location: In-Office Poisition Type: Full Time Department: Medical Billing/Revenue Cycle Salary: $18.25 to $25.00 per hour dependent on Experience $2500.00 sign-on bonus for those who qualify POSITION OVERVIEW: We are seeking an experienced Medical Biller to join our in-office billing team. The ideal candidate will have strong hands-on knowledge of the medical billing and revenue cycle process, and be comfortable working directly within Change Healthcare, SSI, insurance carrier portals, and other payer systems. This position requires someone who understands how to research, correct, update, and resubmit claims, and can also identify the underlying reason a claim has been denied or requires correction. The successful candidate must be detail-oriented, analytical, and capable of independently resolving billing issues rather than simply submitting claims. KEY RESPONSIBILITIES: - Review medical claims for accuracy, completeness, and payer requirements.
- Research and correct denied, rejected, suspended, and incorrectly billed claims.
- Update and correct claims through Change Healthcare and SSI portal
- Access and navigate individual insurance carrier portals to correct and resubmit claims
- Identify and correct claim errors involving:
- CPT codes
- ICD-10 diagnosis codes
- Revenue codes
- Modifiers
- Units
- Charges
- Provider information
- Place of service
- Authorization information
- Patient and insurance demographics
- Other payer-specific requirements.
- Review claims to ensure the diagnosis code supports and is appropriate for the CPT code(s) billed.
- Verify that CPT and diagnosis combinations meet the payer billing requirements.
- Update and correct APG rates when applicable.
- Review and update revenue codes based on the services rendered and payer requirements.
- Investigate claim edits and payer rejections and determine the appropriate correction.
- Resubmit corrected claims through the appropriate clearinghouse or payer portal
- Monitor corrected claims to ensure they are successfully accepted and processed
- Review payer responses, claim status, EOBs, ERAs, and denial information
- Contact insurance carriers when additional research or clarification is required
- Document claim corrections, payer communications, and follow-up activity accurately.
- Identify recurring billing issues and communicate trends to management
- Maintain productivity and quality standards which ensure accuracy
- Work independently while managing assigned accounts and claim follow-up within established timeframes.
BENEFITS: - Medical/Dental/Vision coverage offered
- 401K
- Paid Time Off (Sick/Vacation/Personal)
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