Medical Biller

Position: Medical Biller
Setup: Remote
Schedule: 8 working hours per day + 1-hour unpaid break

Job Summary

We are looking for an experienced Medical Biller with a strong ability to read, interpret, and analyze U.S. medical records, process healthcare insurance claims, and verify medical bills against provider estimates, approved procedures, and final charges.

The ideal candidate must be able to review and understand medical documentation related to MRI, Physical Therapy, Pain Management, PRP (Platelet-Rich Plasma) Injections, Chiropractic Care, and Shockwave Therapy. A graduate of a medical-related course is preferred.

Key Responsibilities

• Request, review, and validate medical bills and medical records from healthcare providers.
• Read, interpret, and analyze medical records, including clinical notes, diagnoses, imaging reports, treatment plans, procedures, and supporting documentation.
• Review medical records related to MRI, Physical Therapy, Pain Management, PRP Injections, Chiropractic Care, and Shockwave Therapy.
• Compare provider estimates and approved procedures against final medical bills to verify the accuracy and appropriateness of billed services.
• Identify billing discrepancies, coding errors, missing documentation, and inconsistencies between medical records, approved treatments, and billed charges.
• Assign, verify, and apply appropriate ICD-10-CM, CPT, and HCPCS codes based on documented diagnoses, procedures, and services.
• Prepare, review, and submit accurate medical claims to private insurance companies, Medicare, and Medicaid.
• Verify patient eligibility, insurance coverage, benefits, and authorization requirements.
• Monitor and follow up on unpaid, delayed, denied, or rejected claims.
• Investigate claim denials, determine root causes, make necessary corrections, and resubmit claims when appropriate.
• Post payments, adjustments, and denials accurately in the billing system.
• Communicate with insurance companies and healthcare providers to resolve billing discrepancies and claims-related issues.
• Maintain accurate, complete, and HIPAA-compliant medical billing records and claims documentation.
• Prepare billing, claims status, accounts receivable, and collection reports.

Qualifications

• Experience in U.S. medical billing, medical coding, claims processing, or Revenue Cycle Management (RCM).
• Must be able to read and interpret medical records, including MRI reports, Physical Therapy notes, Pain Management records, PRP Injections, Chiropractic Care, and Shockwave Therapy.
• Knowledge of medical terminology, diagnoses, procedures, and treatment documentation.
• Familiarity with ICD-10-CM, CPT, and HCPCS codes.
• Ability to review medical bills against provider estimates, approved procedures, and final charges to identify discrepancies.
• Knowledge of U.S. healthcare insurance claims and billing processes.