Medical Biller

VITRA Health • Boston, MA

2d • $60,000 - $65,000 • Hybrid

About The Position

The Medical Biller is accountable for the effective administration and continuous improvement of billing and reimbursement operations. Through analysis, problem-solving, and collaboration, this role exercises discretion and independent judgment in addressing complex claims issues, developing process enhancements, and ensuring compliance with payer and regulatory requirements. The Medical Biller contributes to organizational success by optimizing reimbursement processes and supporting strategic revenue cycle initiatives.

Requirements

• Second language is strongly preferred.
• Bachelor's degree required; concentration in Healthcare Administration, Business Administration, Finance, or related field preferred.
• Minimum of 5 years of progressive experience in medical billing, revenue cycle management, claims analysis, authorization management, and reimbursement optimization.
• Demonstrated experience independently resolving complex payer issues and recommending operational improvements.
• Advanced proficiency with Microsoft Office Suite, including reporting and analysis tools.
• Excellent analytical, problem-solving, customer service, and communication skills.
• Prior experience with Salesforce, Optum, WellSky, RingCentral, or similar healthcare technology platforms.
• Strong understanding of healthcare reimbursement methodologies, payer regulations, and revenue cycle best practices.
• Proven ability to exercise independent judgment and make decisions affecting billing operations and financial outcomes.
• Experience analyzing trends, interpreting data, and developing recommendations to improve organizational performance.
• Demonstrated ability to work independently with minimal supervision and manage multiple priorities effectively.
• Ability to withstand varying job pressures, organize and prioritize responsibilities, and maintain exceptional attention to detail.
• Adheres to client confidentiality.

Nice To Haves

• Second language is strongly preferred.
• concentration in Healthcare Administration, Business Administration, Finance, or related field preferred.

Responsibilities

• Lead the management of billing and reimbursement activities across multiple insurance payers, ensuring timely and accurate revenue collection.
• Analyze and resolve complex claim denials, payment discrepancies, and reimbursement issues through independent review and decision-making.
• Evaluate payer trends and reimbursement patterns, recommending process improvements to enhance revenue cycle performance.
• Review and approve claim submissions to ensure compliance with payer requirements, organizational policies, and regulatory standards.
• Manage the eligibility and authorization processes, identifying risks and implementing corrective actions to minimize disruptions in reimbursement.
• Oversee reauthorization activities and develop strategies to ensure continuity of services and payment.
• Collaborate with clinical, operational, and leadership teams to assess billing practices and implement solutions that improve efficiency and financial outcomes.
• Serve as a subject matter expert on payer requirements, reimbursement methodologies, and revenue cycle best practices.
• Monitor billing performance metrics, prepare reports, identify trends, and make recommendations to leadership regarding operational improvements.
• Develop, document, and implement billing workflows, procedures, and process enhancements that support organizational objectives.
• Provide guidance and training to team members regarding billing procedures, payer updates, and reimbursement best practices.
• Remain current on industry regulations, payer changes, and reimbursement trends through professional development and participation in relevant organizations.
• Foster a culture of customer service, operational excellence, and commitment to quality care.
• Serve as a brand ambassador for Vitra, reflecting our vision, mission, and values.
• Show genuine interest and compassion for the communities we serve and commitment to the diversity of our clients and team members.
• Other duties as assigned.

Benefits

• Employer sponsored health Insurance with a generous employer match.
• Dental and Vision Benefits.
• Supplemental Benefits
• Life, Accident, Critical Illness and Disability Insurance.
• 401K with a 5% company match.
• Accrued Paid-Time-Off.
• Ten company paid holidays.
• Wellness Benefits.
• Tuition Reimbursement.
• Supportive team structure and company culture with a focus on work/life balance.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level