Job Description

A Medical Biller is responsible for managing the medical billing and revenue cycle process for healthcare providers in the U.S. healthcare system.

This role focuses on:

• Medical billing
• Claims submission
• Denial management
• Accounts receivable (AR) follow-up
• Payment posting
• Insurance verification
• Revenue Cycle Management (RCM)

The Medical Biller ensures healthcare providers receive accurate and timely payments from insurance companies and patients.

Responsibilities

Medical Billing

• Prepare and submit medical claims to insurance companies
• Ensure claims are accurate and compliant with payer guidelines
• Handle claim corrections and resubmissions

Denial Management

• Work on denied or rejected claims
• Perform AR follow-up activities
• Analyze denial reasons and take corrective action
• Communicate with insurance payers for claim resolution

Payment Posting

• Process:
  • ERA (Electronic Remittance Advice)
  • EOB (Explanation of Benefits)
• Reconcile payments and outstanding balances

Insurance Verification

• Verify patient insurance eligibility and benefits
• Confirm coverage details before claim processing

Revenue Cycle Management

• Support end-to-end RCM activities
• Monitor claim status and payment flow
• Improve billing accuracy and revenue collection

Compliance & Documentation

• Follow:
  • Medicare guidelines
  • Medicaid guidelines
  • Commercial payer rules
• Maintain:
  • HIPAA compliance
• Protect patient data confidentiality

Required Skills

Medical Billing Skills

• Medical Billing
• AR Calling
• Denial Management
• Payment Posting
• Revenue Cycle Management (RCM)

Coding Knowledge

• ICD-10
• CPT Codes
• HCPCS Codes

Healthcare Systems

• EHR Software
• Billing Software
• Clearinghouses

Insurance Knowledge

• Medicare
• Medicaid
• Commercial Insurance

Soft Skills

• Attention to Detail
• Analytical Thinking
• Communication Skills
• Problem Solving