Medical Biller II

Whitman Hospital and Medical Clinics • Colfax, WA

1d • Onsite

About The Position

Medical Biller II is responsible for managing the full life cycle of a patient account, claim creation through final resolution. This includes working closely with patients, insurance payers, and internal departments to ensure accurate billing, timely reimbursement, and a positive financial experience for patients. This role supports hospital and clinic services in a Critical Access Hospital (CAH) environment and requires an understanding of payer requirements, revenue cycle workflows, and customer service excellence. The Medical Biller II serves as a key point of contact for both patients and insurance companies, ensuring accounts are handled accurately, efficiently, and compassionately.

Requirements

• High school diploma or GED.
• Minimum of 10 years of hospital billing experience.
• Strong understanding of UB-04 claims, revenue codes, and hospital billing workflows.
• Strong computer skills in data entry, and knowledge of Electronic Medical Record software; Microsoft Office Suite.
• Experience billing in a Critical Access Hospital.
• Experience with hospital denial management and payer appeals.
• Knowledge of ICD-10, CPT, and HCPC’s and hospital charging concepts.

Nice To Haves

• Working knowledge of Epic HB strongly preferred.
• Experience billing Medicare and Medicaid hospital claims strongly preferred.
• Associate’s degree in healthcare administration, business, or related field.
• Completion of medical billing terminology courses.

Responsibilities

• Serve as a point of contact for patient billing inquiries, providing clear and compassionate communication with payers, patients and clients.
• Inform and assist patients with Benefit and billing questions and concerns.
• Educate patients on their financial responsibility, insurance coverage, and payment options
• Assist patients with payment arrangements, financial assistance, and charity care processes
• Work in partnership with patients to resolve payer denials regarding Coordination of benefits, eligibility or questionnaires to ensure payer processing
• Prepare, review, and submit clean claims (UB-04 and/or professional) in compliance with payer requirements
• Resolve claim edits, holds, and errors prior to submission
• Submit corrected, replacement, and adjustment claims as needed
• Coordinate timely primary, secondary, and tertiary billing processes
• Perform timely follow-up with insurance companies on unpaid, underpaid, or denied claims.
• Analyze remittance advice (ERA/EOB) to ensure accurate payment and identify underpayments.
• Research and resolve denials related to coding, medical necessity, authorizations, eligibility, etc.
• Identify trends and collaborate with internal teams to prevent recurring issues
• Escalate complex reimbursement issues to the Senior Manager of Billing & Reimbursement as appropriate.
• Research and resolve hospital billing denials using Epic documentation, coding review, and clinical validation.
• Identify root causes of recurring denials and collaborate with coding, clinical departments, and front-end teams to prevent reoccurrence.
• Maintain clear and compliant account documentation within Epic.
• Support denial trending and performance improvement initiatives.
• Utilize Epic HB work queues, dashboards, and reporting tools to manage daily billing and A/R workload.
• Maintain accurate account notes, claim statuses, and follow-up actions in Epic.
• Identify Epic workflow issues or system errors impacting billing and reimbursement.
• Participate in Epic upgrades, testing, and optimization efforts related to hospital billing and reimbursement.
• Ensure billing practices comply with CMS, Medicare, Medicaid, and payer regulations.
• Support audits, payer reviews, and medical record requests related to hospital claims.
• Assist leadership with data gathering and documentation related to cost report preparation and reimbursement analysis.
• Adhere to hospital policies, HIPAA requirements, and billing compliance standards.
• Provide cross-coverage within the Patient Financial Services or Patient Access teams as needed.
• Assist with patient billing inquiries related to hospital accounts in a professional and compassionate manner.
• Participate in department meetings, training, and performance improvement initiatives.

Benefits

• medical
• dental
• vision
• life insurance
• retirement options (403(b) & 457)
• Medical insurance coverage begins on day one and is available to both full time and part time employees.
• discounts on medical services provided by Whitman Hospital and Medical Clinics.
• Differentials apply for evening, night, and weekend shifts.
• unique PTO plan enables employees to increase their accrual with each year of service!

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 11-50 employees