Medical Biller- Full Time

$41,600 - $49,920/Yr

TnT Healthcare Billing Solutions - Apple Valley, MN

Full-time - Entry Level

Hybrid - Apple Valley, MN

Professional, Scientific, and Technical Services

About the position

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. The Medical Biller will be responsible for reviewing medical documentation and accurately assigning appropriate codes using ICD-10, CPT, and HCPCS code sets, ensuring coding compliance with industry standards, payer guidelines, and regulatory requirements. In this position, the Medical Biller will generate accurate and complete claims based on coded information and submit claims electronically or by paper according to payer requirements. They will validate claim information, including patient and provider details, services rendered, and billed amounts. The role also includes monitoring and tracking claim submissions to insurance companies, following up on unpaid or denied claims, and investigating reasons for denials or rejections. The Medical Biller will take necessary actions to resolve claim issues, including submitting appeals, correcting errors, or resubmitting claims. Additionally, the Medical Biller will accurately post payments and adjustments received from insurance companies, patients, and other payers, identifying and resolving payment discrepancies, including overpayments, underpayments, and non-payments. They will communicate with insurance companies to verify coverage, resolve claim issues, and obtain necessary information, while also interacting with patients to address billing inquiries, explain charges, and assist with payment arrangements. The Medical Biller will maintain accurate and organized records of billing activities, claim status, and payment history, generating reports on billing and reimbursement metrics, identifying trends, issues, and opportunities for improvement. Compliance with coding and billing regulations, including HIPAA and relevant billing standards, is essential, as is participation in internal quality assurance activities to maintain accuracy and adherence to best practices.

Responsibilities

• 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.
• 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.
• 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.
• 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.
• 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.
• 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.
• Ensure compliance with coding and billing regulations, including HIPAA and relevant billing standards.

Requirements

• 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.

Nice-to-haves

• Experience with electronic health record (EHR) systems.
• Additional certifications in medical billing or coding.