Medical Biller

Aston Carter•Town of Wallkill, NY

2d•$19 - $22•Onsite

About The Position

The Medical Biller is responsible for the accurate and timely submission of professional and technical medical claims, as well as the proactive research and resolution of unpaid or underpaid claims. This role works closely with insurance carriers, patients, and internal staff to resolve billing issues, secure appropriate reimbursement, and maintain compliant billing practices across physician offices and specialty practices.

Requirements

Minimum of 1-3 years of medical billing experience.
Strong knowledge of insurance billing practices for commercial insurance, Medicare, Medicaid, and other third-party payers.
Proficiency with medical billing software and electronic claims submission.
Experience with eClinicalWorks or similar electronic health record and billing systems.
Solid understanding of healthcare billing processes and payer guidelines.
Ability to research, analyze, and resolve unpaid, denied, or underpaid claims.
Strong attention to detail and accuracy in claim preparation, posting, and reconciliation.
Effective verbal and written communication skills for interacting with patients, insurance companies, and internal staff.
Ability to handle patient billing concerns in a professional, customer-focused manner.
Ability to maintain confidentiality and comply with HIPAA standards.

Nice To Haves

High school diploma or equivalent.
Experience working in healthcare or physician office billing environments.
Familiarity with eClinicalWorks practice management and billing modules.
Ability to organize and prioritize work to manage multiple accounts and deadlines.
Comfort with participating in ongoing training, educational activities, and staff meetings.
Interest in professional growth and advancement within a growing back-office team.

Responsibilities

Prepare, review, and submit clean medical claims to commercial insurance carriers, Medicare, Medicaid, and other third-party payers using both electronic and paper formats.
Research, track, and follow up on unpaid, denied, or underpaid insurance claims to ensure timely reimbursement.
Communicate directly with insurance companies to resolve claim rejections, denials, coding issues, and payment discrepancies.
Review patient accounts for accuracy and completeness, obtaining missing or corrected demographic, insurance, or clinical information as needed.
Correct, resubmit, and appeal claims when necessary, ensuring compliance with payer guidelines and billing regulations.
Respond to inquiries from patients, insurance companies, and internal staff regarding billing status, coverage, and payment issues.
Identify and resolve patient billing concerns in a professional and customer-focused manner.
Generate and distribute patient statements and clearly explain balances, insurance payments, and patient responsibility.
Evaluate patient financial situations and assist with establishing payment plans when appropriate.
Monitor delinquent accounts, document all follow-up activity, and escalate accounts for collections when necessary.
Prepare documentation and recommendations for account assignment to collection agencies, as applicable.
Post and reconcile payments from insurance carriers and patients and prepare accurate daily deposit records.
Maintain accurate billing records and ensure all activities comply with HIPAA and confidentiality standards.
Perform routine system maintenance tasks, including daily data backups.
Participate in ongoing training, educational activities, and monthly staff meetings to stay current with billing practices and payer requirements.
Conduct all duties in accordance with company policies and procedures.
Perform other related duties as assigned to support the overall effectiveness of the billing operations.