Medical Biller

Job Title: Billing Specialist (Revised)

Job Summary: The Billing Specialist is responsible for preparing, submitting, and following up on claims to ensure accurate and timely reimbursement from insurance companies, government programs, and patients. This role plays a critical part in the financial cycle of healthcare delivery by managing the billing process from claim creation to payment resolution.

Job Responsibilities/Tasks:

• Keys charge information into entry program and produces billing.
• Assists in the processing of insurance claims including Medicare, HMO and Commercial claims
• Follow up on unpaid claims within standard billing cycle time frame.
• Resolve billing issues and resubmit denied or rejected claims.
• Work closely with patients to explain charges, set up payment plans, and collect outstanding balances.
• Verify insurance benefits and eligibility as needed.
• Stay updated on payer regulations, coding guidelines, and billing best practices.
• Collaborate with clinical documentation specialist, front desk, communication center and clinical staff to resolve discrepancies and improve claim accuracy.