Medical Biller

TEKsystems•San Diego, CA

6d•$28 - $28•Remote

About The Position

We are seeking an experienced Medical Biller to join our team. This role focuses on investigating and resolving credit balances on patient accounts, particularly those involving government payers such as Medicare and Medicaid. The ideal candidate will have strong analytical skills, attention to detail, and the ability to work independently.

Requirements

Ability to work independently and manage priorities effectively.
Strong proficiency in Excel and general computer skills.
Knowledge of Accounts Receivable (AR) follow-up processes.
Understanding of billing practices, including CPT codes.
Experience with EPIC or similar billing systems.
Minimum of 5+ years of relevant experience, with the autonomy to manage complex tasks.

Responsibilities

Investigate and resolve credit balances on patient accounts, with emphasis on government payers.
Review aged transactions to identify root causes of overpayments and determine appropriate resolution paths.
Ensure timely processing of refunds in compliance with CMS 60-day refund rules and other regulatory guidelines.
Collaborate with billing, compliance, and finance teams to validate refund accuracy and prevent recurrence.
Document findings and maintain audit-ready records for all credit balance resolutions.
Monitor and report progress on backlog reduction, highlighting risks and compliance concerns.
Support internal and external audit requests related to credit balances and payer activity.
Stay current on changes in billing regulations, payer policies, and reimbursement methodologies.
Record all collection activities and communications in the billing system per department policies.
Work with billing, coding, and registration teams to resolve account discrepancies and ensure claim accuracy.
Process refunds, adjustments, and write-offs in compliance with organizational policies.
Maintain compliance with HIPAA, CMS, and other regulatory requirements related to patient privacy and billing practices.