Medical Biller- Full Time
1 week ago
TNT Healthcare Billing Solutions is seeking a dedicated and detail-oriented Medical Biller to manage full-cycle revenue operations for medical clinics throughout the Twin Cities. The ideal candidate will possess in-depth knowledge of medical billing, coding, insurance claims processing, and revenue cycle management. This role involves end-to-end management of the billing process, from patient registration to final payment, ensuring accuracy, compliance, and efficiency.
Responsibilities:
Medical Billing and Coding:
- Review medical documentation and accurately assign appropriate codes using ICD-10, CPT, and HCPCS code sets.
- Ensure coding compliance with industry standards, payer guidelines, and regulatory requirements.
- Verify and update patient demographic and insurance information as necessary.
Claim Generation and Submission:
- Generate accurate and complete claims based on coded information.
- Submit claims electronically or by paper according to payer requirements.
- Validate claim information, including patient and provider details, services rendered, and billed amounts.
Claim Follow-Up and Resolution:
- Monitor and track claim submissions to insurance companies.
- Follow up on unpaid or denied claims, investigating reasons for denials or rejections.
- Take necessary actions to resolve claim issues, including submitting appeals, correcting errors, or resubmitting claims.
Payment Posting and Reconciliation:
- Accurately post payments and adjustments received from insurance companies, patients, and other payers.
- Identify and resolve payment discrepancies, including overpayments, underpayments, and non-payments.
- Reconcile accounts receivable balances and ensure accuracy of financial records.
Insurance and Patient Communication:
- Communicate with insurance companies to verify coverage, resolve claim issues, and obtain necessary information.
- Interact with patients to address billing inquiries, explain charges, and assist with payment arrangements.
- Provide clear and concise explanations of insurance benefits, patient responsibilities, and payment options.
Documentation and Reporting:
- Maintain accurate and organized records of billing activities, claim status, and payment history.
- Generate reports on billing and reimbursement metrics, identifying trends, issues, and opportunities for improvement.
- Adhere to confidentiality and privacy regulations in handling sensitive patient and billing information.
Compliance and Quality Assurance:
- Stay updated on industry changes, regulatory guidelines, and insurance policies related to medical billing.
- Ensure compliance with coding and billing regulations, including HIPAA and relevant billing standards.
- Participate in internal quality assurance activities to maintain accuracy and adherence to best practices.
Qualifications:
- High school diploma or equivalent; additional certification in medical billing or coding is preferred.
- Proven experience as a Medical Biller or in a similar role.
- Strong knowledge of medical billing procedures, coding systems (ICD-10, CPT, HCPCS), and insurance regulations.
- Proficiency in medical billing software and electronic health record (EHR) systems.
- Excellent attention to detail, with the ability to accurately review and analyze medical documentation.
- Strong communication skills, both written and verbal, with the ability to interact professionally with insurance companies, providers, and patients.
- Ability to work independently and meet deadlines in a fast-paced environment.
- Problem-solving skills, with the ability to identify and resolve claim-related issues.
- Familiarity with medical terminology and healthcare billing practices.
Location: Hybrid- Training will be fully in office & position will transition to hybrid after successful training
Job Type: Full-Time
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