Medical Biller in stockton, California at Emmi

About the Role:

The Medical Biller plays a critical role in the healthcare revenue cycle by ensuring accurate and timely billing for medical services rendered. This position involves managing patient billing processes, and submitting claims to insurance companies for reimbursement. Responsibilties include but are not limited to, making calls to patients to set up payment plans, making calls to insurance companies. The Medical Biller must maintain compliance with healthcare regulations and coding standards such as CPT and ICD-10 to minimize claim denials and delays. By effectively posting payments and resolving billing discrepancies, the Medical Biller supports the financial health of the medical practice or facility. Ultimately, this role ensures that healthcare providers receive appropriate compensation while maintaining positive relationships with patients and insurers.

Minimum Qualifications:

• High school diploma or equivalent required; associate degree or certification in medical billing or coding preferred.
• Proven experience with medical billing processes and familiarity with CPT and ICD-10 coding systems.
• Knowledge of medical insurance policies and procedures, including claim submission and payment posting.
• Proficiency in electronic billing software and medical billing platforms.
• Strong attention to detail and ability to maintain confidentiality of patient information.

Preferred Qualifications:

• Certification from recognized organizations such as the AAPC (Certified Professional Biller) or AHIMA (Certified Coding Associate).
• Experience working in a healthcare setting such as a hospital, clinic, or physician’s office.
• Familiarity with ICD-10 coding, CPT, MediCal, Medicare, CCS and private insurance compnaies and updates to medical billing regulations.
• Advanced skills in medical billing software and electronic health record (EHR) systems.
• Excellent communication and problem-solving skills to handle complex billing issues.
• Strong communictation skills

Responsibilities:

• Review and process patient billing information accurately and efficiently.
• Assign appropriate CPT and ICD-10 codes to medical procedures and diagnoses based on documentation.
• Prepare and submit medical claims electronically to insurance companies and follow up on unpaid or denied claims.
• Post payments received from patients and insurance providers, reconciling accounts as necessary.
• Communicate with patients, healthcare providers, and insurance companies to resolve billing issues and answer inquiries.

Skills:

The required skills such as patient billing, CPT coding, and medical insurance knowledge are essential for accurately translating medical services into billable claims and ensuring compliance with healthcare standards. Medical coding expertise, including ICD-10, is used daily to assign correct codes that affect reimbursement and reporting. Electronic billing skills enable the efficient submission and tracking of claims, reducing errors and speeding up payment cycles. Posting payments accurately requires attention to detail and familiarity with billing software to maintain up-to-date patient accounts. Preferred skills like advanced coding certifications and experience with EHR systems enhance the ability to manage complex billing scenarios and improve overall workflow efficiency.