Job Description: Certified Medical Biller
A Certified Medical Biller is responsible for managing the billing process for healthcare providers to ensure accurate and timely submission of medical claims to insurance companies, government programs, and patients. This role involves verifying patient information, coding medical procedures using ICD-10, CPT, and HCPCS codes, preparing and submitting insurance claims, following up on unpaid claims, and resolving billing issues. The medical biller works closely with healthcare providers, insurance companies, and patients to ensure compliance with healthcare regulations and maximize reimbursement.
Key Responsibilities:
Accurately prepare and submit claims to insurance companies and third-party payers.
Review and verify patient data and insurance information.
Apply appropriate billing codes (ICD-10, CPT, HCPCS) based on medical documentation.
Monitor claim status and follow up on unpaid or denied claims.
Communicate with insurance companies to resolve billing discrepancies.
Generate patient invoices and respond to billing inquiries.
Maintain billing records and ensure compliance with HIPAA and other regulations.
Collaborate with medical coders, providers, and administrative staff.
Qualifications:
Certification from a recognized medical billing program (e.g., AAPC, AMBA, AHIMA).
Proficiency in medical billing software and electronic health records (EHR) systems.
Strong understanding of medical terminology and insurance processes.
Excellent attention to detail and organizational skills.
Effective communication and problem-solving abilities.