The Medical Biller is responsible for managing the administrative process of submitting insurance claims to payers on behalf of a healthcare provider. This includes verifying patient insurance coverage, preparing and submitting accurate medical bills, following up on unpaid claims, resolving billing discrepancies, and communicating with patients regarding outstanding balances to support timely payment for medical services rendered.

Responsibilities

Create and submit electronic or paper claims to insurance companies, including accurate coding of diagnoses and procedures based on medical records
Check patient insurance eligibility and benefits, and obtain pre-authorizations when necessary
Review medical records for completeness and accuracy to support proper billing
Monitor claim status, contact insurance companies to resolve denials or billing issues, and initiate appeals when needed
Explain patient bills, address billing inquiries, and set up payment plans for outstanding balances
Maintain patient demographic information and billing records in EHR systems
Adhere to HIPAA regulations and stay current on healthcare billing guidelines and coding practices
Perform other duties as assigned